Endovascular recanalization for subacute symptomatic intracranial arterial occlusion: A report of two cases

BackgroundWe hope to illustrate the feasibility of endovascular recanalization for intracranial symptomatic arterial occlusion in the subacute period without adjunctive stenting.Case descriptionTwo patients presented with recurrent transient ischemic attacks due to subacute occlusion of intracranial vessels (left MCA M1 and basilar artery). Both had pressor-dependent ischemic symptoms referable to the occluded artery. Sustained angiographic antegrade flow was achieved following angioplasty of our first patient’s occluded basilar artery. Excellent angiographic perfusion of our second patient’s left hemisphere was achieved following angioplasty of her occluded M1. A Maverick 2 mm × 9 mm balloon was employed in both cases, neither requiring chemical thrombolysis.ConclusionSymptoms in both patients abated and they were weaned off pressors within 24 h, underscoring the potential of angioplasty to treat fluctuating, pressor-dependent cerebral ischemia from subacute intracranial arterial occlusion. At most recent follow-up, both patients were neurologically intact, denying any transient neurologic events occurring in the interim.