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Neurol Res. 2005;27 Suppl 1:S84-8.

Endovascular reconstruction by means of stent placement in symptomatic intracranial atherosclerotic stenosis.

Author information

1
Department of Neurosurgery, Endovascular Neurosurgery and Interventional Neuroradiology, ENERI, Clínica Médica Belgrano, Buenos Aires, Argentina. plylyk@lylyk.com.ar

Abstract

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.

PMID:
16197831
DOI:
10.1179/016164105X35495
[Indexed for MEDLINE]
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