Literature DB >> 22200014

Urgent recanalization with stenting for severe intracranial atherosclerosis after transient ischemic attack or minor stroke.

Tae Sik Park1, Beom Jin Choi, Tae Hong Lee, Joon Suk Song, Dong Youl Lee, Sang Min Sung.   

Abstract

OBJECTIVE: Stenting of symptomatic intracranial stenosis has recently become an alternative treatment modality. However, urgent intracranial stenting in patients with intracranial stenosis following a transient ischemic attack (TIA) or minor stroke is open to dispute. We sought to assess the feasibility, safety, and effectiveness of urgent intracranial stenting for severe stenosis (>70%) in TIA or minor stroke patients.
METHODS: Between June 2009 and October 2010, stent-assisted angioplasty by using a balloon-expandable coronary stent for intracranial severe stenosis (>70%) was performed in 7 patients after TIA and 5 patients after minor stroke (14 stenotic lesions). Technical success rates, complications, angiographic findings, and clinical outcomes were retrospectively analyzed.
RESULTS: Stenting was successful in all 12 patients. The mean time from symptom onset to stenting was 2.1 days (1-8 days). Post-procedural angiography showed restoration to a normal luminal diameter in all patients. In-stent thrombosis occurred in one patient (n=1, 8.3%), and was lysed with abciximab. No device-related complications, such as perforations or dissections at the target arteries or intracranial hemorrhaging, occurred in any patient. The mortality rate was 0%. No patient had an ischemic event over the mean follow-up period of 12.5 months (range, 7-21 months), and follow-up angiography (n=7) revealed no significant in-stent restenosis (>50%).
CONCLUSION: Urgent recanalization with stenting is feasible, safe, and effective in patients with TIA or acute minor stroke with intracranial stenosis of ≥70%.

Entities:  

Keywords:  Acute ischemic stroke; Intracranial atherosclerosis; Intracranial stenting; Transient ischemic attack

Year:  2011        PMID: 22200014      PMCID: PMC3243835          DOI: 10.3340/jkns.2011.50.4.322

Source DB:  PubMed          Journal:  J Korean Neurosurg Soc        ISSN: 1225-8245


  13 in total

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2.  Predictors of ischemic stroke in the territory of a symptomatic intracranial arterial stenosis.

Authors:  Scott E Kasner; Marc I Chimowitz; Michael J Lynn; Harriet Howlett-Smith; Barney J Stern; Vicki S Hertzberg; Michael R Frankel; Steven R Levine; Seemant Chaturvedi; Curtis G Benesch; Cathy A Sila; Tudor G Jovin; Jose G Romano; Harry J Cloft
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3.  Intracranial angioplasty with Gateway-Wingspan system for symptomatic atherosclerotic stenosis: preliminary results of 27 Chinese patients.

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5.  Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis.

Authors:  Marc I Chimowitz; Michael J Lynn; Harriet Howlett-Smith; Barney J Stern; Vicki S Hertzberg; Michael R Frankel; Steven R Levine; Seemant Chaturvedi; Scott E Kasner; Curtis G Benesch; Cathy A Sila; Tudor G Jovin; Jose G Romano
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7.  Treatment of symptomatic middle cerebral artery stenosis with balloon-mounted stents: long-term follow-up at a single center.

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8.  Stroke risk after transient ischemic attack in a population-based setting.

Authors:  Lynda D Lisabeth; Jennifer K Ireland; Jan M H Risser; Devin L Brown; Melinda A Smith; Nelda M Garcia; Lewis B Morgenstern
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9.  Carotid artery stenting in recently symptomatic patients: a single center experience.

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10.  Consensus conference on intracranial atherosclerotic disease: rationale, methodology, and results.

Authors:  Adnan I Qureshi; Edward Feldmann; Camilo R Gomez; S Claiborne Johnston; Scott E Kasner; Donald C Quick; Peter A Rasmussen; M Fareed K Suri; Robert A Taylor; Osama O Zaidat
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1.  Percutaneous transluminal angioplasty and stenting for severe stenosis of the intracranial extradural internal carotid artery causing transient ischemic attack or minor stroke.

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Review 2.  Role of stenting for intracranial atherosclerosis in the post-SAMMPRIS era.

Authors:  Dale Ding; Robert M Starke; R Webster Crowley; Kenneth C Liu
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