BACKGROUND AND PURPOSE: Stent placement has been applied in small case series as a rescue therapy in combination with different thrombolytic agents, percutaneous balloon angioplasty (PTA), and mechanical thromboembolectomy (MT) in acute stroke treatment. These studies report a considerable mortality and a high rate of intracranial hemorrhages when balloon-mounted stents were used. This study was performed to evaluate feasibility, efficacy, and safety of intracranial artery recanalization for acute ischemic stroke using a self-expandable stent. METHODS: All patients treated with an intracranial stent for acute cerebral artery occlusion were included. Treatment comprised intraarterial thrombolysis, thromboaspiration, MT, PTA, and stent placement. Recanalization result was assessed by follow-up angiography immediately after stent placement. Complications related to the procedure and outcome at 3 months were assessed. RESULTS: Twelve patients (median NIHSS 14, mean age 63 years) were treated with intracranial stents for acute ischemic stroke. Occlusions were located in the posterior vertebrobasilar circulation (n=6) and in the anterior circulation (n=6). Stent placement was feasible in all procedures and resulted in partial or complete recanalization (TIMI 2/3) in 92%. No vessel perforations, subarachnoid, or symptomatic intracerebral hemorrhages occurred. One dissection was found after thromboaspiration and PTA. Three patients (25%) had a good outcome (mRS 0 to 2), 3 (25%) a moderate outcome (mRS 3), and 6 (50%) a poor outcome (mRS 4 to 6). Mortality was 33.3%. CONCLUSIONS: Intracranial placement of a self-expandable stent for acute ischemic stroke is feasible and seems to be safe to achieve sufficient recanalization.
BACKGROUND AND PURPOSE: Stent placement has been applied in small case series as a rescue therapy in combination with different thrombolytic agents, percutaneous balloon angioplasty (PTA), and mechanical thromboembolectomy (MT) in acute stroke treatment. These studies report a considerable mortality and a high rate of intracranial hemorrhages when balloon-mounted stents were used. This study was performed to evaluate feasibility, efficacy, and safety of intracranial artery recanalization for acute ischemic stroke using a self-expandable stent. METHODS: All patients treated with an intracranial stent for acute cerebral artery occlusion were included. Treatment comprised intraarterial thrombolysis, thromboaspiration, MT, PTA, and stent placement. Recanalization result was assessed by follow-up angiography immediately after stent placement. Complications related to the procedure and outcome at 3 months were assessed. RESULTS: Twelve patients (median NIHSS 14, mean age 63 years) were treated with intracranial stents for acute ischemic stroke. Occlusions were located in the posterior vertebrobasilar circulation (n=6) and in the anterior circulation (n=6). Stent placement was feasible in all procedures and resulted in partial or complete recanalization (TIMI 2/3) in 92%. No vessel perforations, subarachnoid, or symptomatic intracerebral hemorrhages occurred. One dissection was found after thromboaspiration and PTA. Three patients (25%) had a good outcome (mRS 0 to 2), 3 (25%) a moderate outcome (mRS 3), and 6 (50%) a poor outcome (mRS 4 to 6). Mortality was 33.3%. CONCLUSIONS: Intracranial placement of a self-expandable stent for acute ischemic stroke is feasible and seems to be safe to achieve sufficient recanalization.
Authors: M Möhlenbruch; M Seifert; T Okulla; U Wüllner; D R Hadizadeh; M Nelles; S Greschus; K Wilhelm; H H Schild; T Klockgether; H Urbach Journal: Clin Neuroradiol Date: 2011-10-05 Impact factor: 3.649
Authors: J S Bang; C W Oh; C Jung; S Q Park; K J Hwang; H-S Kang; M H Han; S H Lee; Y S Chung; O-K Kwon Journal: AJNR Am J Neuroradiol Date: 2010-04-01 Impact factor: 3.825
Authors: P Mordasini; N Frabetti; J Gralla; G Schroth; U Fischer; M Arnold; C Brekenfeld Journal: AJNR Am J Neuroradiol Date: 2010-10-21 Impact factor: 3.825
Authors: Z Kulcsár; C Bonvin; V M Pereira; S Altrichter; H Yilmaz; K O Lövblad; R Sztajzel; D A Rüfenacht Journal: AJNR Am J Neuroradiol Date: 2009-12-17 Impact factor: 3.825
Authors: Jens Fiehler; Michael Söderman; Francis Turjman; Philip M White; Søren Jacob Bakke; Salvatore Mangiafico; Rüdiger von Kummer; Mario Muto; Christophe Cognard; Jan Gralla Journal: Neuroradiology Date: 2012-09-05 Impact factor: 2.804
Authors: P Mordasini; C Brekenfeld; J V Byrne; U Fischer; M Arnold; S Jung; G Schroth; J Gralla Journal: AJNR Am J Neuroradiol Date: 2012-07-26 Impact factor: 3.825
Authors: C Brekenfeld; G Schroth; P Mordasini; U Fischer; M-L Mono; A Weck; M Arnold; M El-Koussy; J Gralla Journal: AJNR Am J Neuroradiol Date: 2011-05-12 Impact factor: 3.825