Treatment of a Symptomatic Severe Basilar Artery Stenosis with Balloon Dilatation (NeuroSpeed) Followed by the Implantation of a Self-Expanding Stent (Credo) with Good Clinical Outcome and Follow-Up

Intracranial atherosclerotic stenosis (ICAS) is a major cause of cerebral ischemia and is associated with a high risk of recurrent stroke, with an incidence of ischemic stroke as high as 42–54% in the Asian population. In the United States and Europe, ICAS causes 8–10% of all ischemic strokes. The medicinal and endovascular treatment of ICAS has been widely debated in the literature, with the use of balloon-mounted or self-expanding stents for the treatment of ICAS with variable reported results. We describe a representative case of a 58-year-old patient with critical symptomatic basilar artery stenosis treated with balloon dilatation (NeuroSpeed, Acandis) followed by implantation of a self-expanding stent (Credo, Acandis) with good results. Endovascular treatment of atherosclerotic intracranial arterial stenosis with balloon dilatation and self-expanding stent deployment versus implantation of balloon-expandable stents is the main topic of this chapter.