OBJECTIVE: Patients with intracranial atherosclerosis who fail antithrombotic therapy have a poor prognosis. The high rate of recurrent stroke warrants testing alternative treatments such as intracranial angioplasty. METHODS: We present our experience in the treatment of 104 patients (age range, 54-82 years; mean age, 67 years) with symptomatic intracranial atherosclerotic stenoses despite medical therapy who underwent stent-assisted angioplasty. Patient records were retrospectively analysed for location and degree of stenosis, regimen of antiplatelet agents, devices used, procedure-related complications and adverse events. Clinical (Modified Rankin Scale) and radiographic outcomes were obtained 24 hours, 1 month and 3-6 months after treatment. Sixty-five lesions (62.5%) were located in the posterior circulation. Mean stenosis was 75.4%. RESULTS: In all patients, the angiographic degree of stenosis was reduced to less than 30%. One stent was implanted in 66 patients (63%), and two or more in 38 patients (37%). Modified Rankin Scale (mR) was 1-2 in 67.5% of the cases, 3-4 in 25.9%, 5 in 2.8%, 6 in 3.8%. Procedural morbidity was 5.7% and procedural mortality was 3.8%. Angiographic follow-up was available in 58 patients (55.7%) and the restenosis rate was 12.5%. DISCUSSION: In selected patients, endovascular revascularization of intracranial arteries by means of stent-assisted angioplasty is technically feasible, effective and safe.
OBJECTIVE:Patients with intracranial atherosclerosis who fail antithrombotic therapy have a poor prognosis. The high rate of recurrent stroke warrants testing alternative treatments such as intracranial angioplasty. METHODS: We present our experience in the treatment of 104 patients (age range, 54-82 years; mean age, 67 years) with symptomatic intracranial atherosclerotic stenoses despite medical therapy who underwent stent-assisted angioplasty. Patient records were retrospectively analysed for location and degree of stenosis, regimen of antiplatelet agents, devices used, procedure-related complications and adverse events. Clinical (Modified Rankin Scale) and radiographic outcomes were obtained 24 hours, 1 month and 3-6 months after treatment. Sixty-five lesions (62.5%) were located in the posterior circulation. Mean stenosis was 75.4%. RESULTS: In all patients, the angiographic degree of stenosis was reduced to less than 30%. One stent was implanted in 66 patients (63%), and two or more in 38 patients (37%). Modified Rankin Scale (mR) was 1-2 in 67.5% of the cases, 3-4 in 25.9%, 5 in 2.8%, 6 in 3.8%. Procedural morbidity was 5.7% and procedural mortality was 3.8%. Angiographic follow-up was available in 58 patients (55.7%) and the restenosis rate was 12.5%. DISCUSSION: In selected patients, endovascular revascularization of intracranial arteries by means of stent-assisted angioplasty is technically feasible, effective and safe.
Authors: Wiebke Kurre; Friedhelm Brassel; Roland Brüning; Jan Buhk; Bernd Eckert; Susanna Horner; Michael Knauth; Thomas Liebig; Jana Maskova; Dirk Mucha; Vojtech Sychra; Matthias Sitzer; Michael Sonnberger; Marc Tietke; Johannes Trenkler; Bernd Turowski; Joachim Berkefeld Journal: Neuroradiology Date: 2011-01-11 Impact factor: 2.804
Authors: F Nahab; M J Lynn; S E Kasner; M J Alexander; R Klucznik; O O Zaidat; J Chaloupka; H Lutsep; S Barnwell; M Mawad; B Lane; M I Chimowitz Journal: Neurology Date: 2009-03-18 Impact factor: 9.910
Authors: O O Zaidat; R Klucznik; M J Alexander; J Chaloupka; H Lutsep; S Barnwell; M Mawad; B Lane; M J Lynn; M Chimowitz Journal: Neurology Date: 2008-01-30 Impact factor: 9.910