To discuss the importance of balloon angioplasty in Intracranial atherosclerotic disease(ICAD)(>70 % stenosis on DSA) in patients with symptomatic disease despite being on optimum medical management(ecospirin150mg,clopidogrel75mg &atorvastatin40 mg per day)for at least one week.The goal of the present study is to report the role of balloon angioplasty using maverick balloon catheter(Boston scientific)in ICAD.

31 patients ( 20 males and 11 females) with mean age of 54.5 years underwent balloon angioplasty using Maverick balloon catheter(Boston scientific) with <80% vessel diameter under general anesthesia. Clinical presentation mainly included recurrent Transient ischemic attacks and minor strokes despite being on double anti platelet regimen.Inclusion criteria were smaller vessels (≤ 2-mm diameter), longer lesions (>12 mm), distal lesions, tortuous vascular anatomy, and vessels at branch points. Patients who underwent stenting for ICAD in our institution were excluded from this study.19 lesions were in...

Technical success with TICI grade 2/3 was achieved in all cases.we did not encounter any major complications.Asymptomatic Intracerebral hemorrhage is seen in 2 patients. The 30 day stroke or death rate was 2%. Good clinical outcome with mRS <2 was seen in 29 patients.MRA was done on follow up in 21 patients. None of the patients who underwent primary angioplasty required rescue stent placement in our series.None of the patients had new ischemic events on clinical follow up of 1,3 and 6 months and were...

Balloon angioplasty is a safe option and can be effectively used in patients of ICAD with acceptable risks and promising outcomes.we used balloon angioplasty alone in patients with presentation of recurrent ischemic events and avoided stent placement. The major limitation of the present study is it is a retrospective analysis and not a randomized study. Our study is limited to the use of only maverick balloons in the patients. The results of the analysis is needed to further tested by randomized trial in order to...

Qureshi, A.I., Feldmann, E., Gomez, C.R., Johnston, S.C., Kasner, S.E., Quick, D.C., Rasmussen, P.A., Fareed, M., Suri, K., Taylor, R.A. and Zaidat, O.O. Intracranial Atherosclerotic Disease: An Update. Annals of Neurology2009;66: 730-738 Marks MP, Wojak JC, Al-Ali F et al Angioplasty for Symptomatic intracranial stenosis: clinical outcome.Stroke2006;37:1016–1020 Siddiq F, Vazquez G, Memon MZ, Suri MF, Taylor RA, Wojak JC, Chaloupka JC, Qureshi AI. Comparison of primary angioplasty with stent placement for treating symptomatic intracranial atherosclerotic diseases.A multicenter study. Stroke. 2008;39:2505–2510 Alurkar A, Karanam LS, Oak...