Stenting for stenosis of the intacranial cerebral artery has often been reported, and the effectiveness has been confirmed. However, the pitfalls of this treatment for acute cerebral truncal arterial ...occlusion have not been discussed. We encountered two cases of basilar occlusion treated by stenting. Case 1: A sixty-nine-year-old male complained of dizziness and developed consciousness disturbance. Emergency angiography and thrombolysis therapy with percutaneous transluminal angioplasty (PTA) was performed. Recanalization was obtained but stenosis remained. Anticoagulant and antiplatelet agents were continnously administered until the stenting was performed 14 days later. The patient was discharged uneventlfully. Case 2: A sixty-nine-year-old male was admitted with consciousness disturbance. Emergency angiography and thrombolysis therapy were performed. Recanalization was obtained but stenosis persisted. Anticoagulant and antiplatelet agents were administered until stenting was performed 4 weeks later, and good recanalization was obtained. We chose two-stage treatment; that is, intra-arterial thrombolysis with/without PTA in the first stage, followed by stenting in the second stage. The reason we chose two-stage treatment is that during the acute stage of occlusion, the shape of the artery can not be accurately demonstrated. We considered that staged stenting for acute cerebral truncal arterial occlusion using sufficient anti-coagulation and anti-platelet agents is an optimal strategy. More cases are needed to clarify the most stable stenting for acute cerebral truncal artery occlusion.
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