Comparison of periprocedure complications resulting from direct stent placement compared with those due to conventional and staged stent placement in the basilar artery

Abstract

Direct stent placement in the BA is associated with a relatively high complication rate, compared with a staged procedure. Complications may result from an embolic shower following disruption of atheromatous plaque debris attained using high-profile devices such as stents, as demonstrated by the postoperative imaging appearance of acute pontine infarctions. Additionally, displacement of debris by the stent into the ostia (snowplowing) of small brainstem perforating vessels may be responsible for the complications noted. Although direct stent placement in peripheral and coronary vessels has been shown to be safe, the authors suggest that direct stent placement in the BA should be avoided to minimize the risk of periprocedure morbidity.