A 58-year-old man presented with acute onset of neurological deficits. Magnetic resonance imaging showed bilateral cerebellar infarctions. Computed tomography angiogram, and T1 SPACE magnetic resonance imaging showed occlusion of the dominant left vertebral artery. Catheter angiography showed near occlusion of left vertebral artery with luminal thrombus. Angiography performed after 3 weeks of medical therapy showed recanalization of the left vertebral artery but with high-grade stenosis which was successfully treated by percutaneous transluminal angioplasty and stenting. Our case report demonstrates that lesion characterization is important to identify candidates for aggressive medical management with interval percutaneous transluminal angioplasty and stenting, especially when the mechanism of stroke is due to acute plaque destabilization.
Cite this article as: Raghuram K, Chaudhary RK. Aggressive medical management followed by interval balloon angioplasty and stenting in an acutely symptomatic patient with intracranial stenosis. Imaging Interv. 2022;2(1):9-11.