Role of Balloon-Expandable Stents in Intracranial Atherosclerotic Disease in a Series of 182 Patients

被引:20
作者
Alurkar, Anand [1 ]
Karanam, Lakshmi Sudha Prasanna [1 ]
Oak, Sagar [1 ]
Nayak, Suresh [1 ]
Sorte, Sandeep [1 ]
机构
[1] King Edward Mem Hosp, Dept Neurointervent, Pune 411011, Maharashtra, India
关键词
intracranial stenosis; stenting; stroke; DRUG-ELUTING STENTS; INITIAL-EXPERIENCE; ARTERY; THERAPY; STROKE;
D O I
10.1161/STROKEAHA.113.001446
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose-To demonstrate the safety and efficacy of balloon-expandable intracranial stents in patients with intracranial atherosclerotic lesions (>70% stenosis) who were symptomatic despite being on optimum medical therapy. Methods-Between April 2004 and May 2012, 182 patients underwent intracranial stenting in our institution. All patients had symptoms despite being on optimum medical therapy. Clinical follow-up was done at 1, 3, 6, and 12 months. Angiographic follow-up was done at 1 year in 121 patients. Results-Technical success was achieved in 97.44% of the cases. The incidence of all strokes at 1 month after procedure was 11 (5.64%), of which 2 (1.02%) were major, both related to stent thrombosis not responding to tirofiban, and 9 (4.61%) were minor. Periprocedural minor stroke was seen in 9 patients. There were 2 deaths in our study (mortality=1.09%). Conclusions-Treatment of intracranial atherosclerotic disease with balloon-expandable intracranial stents is a safe and effective method with acceptable adverse events, especially in patients who failed medical therapy and were symptomatic despite being on optimum medical therapy.
引用
收藏
页码:2000 / +
页数:7
相关论文
共 15 条
[1]   Drug-eluting stents for the treatment of intracranial atherosclerosis - Initial experience and midterm angiographic follow-up [J].
Abou-Chebl, A ;
Bashir, Q ;
Yadav, JS .
STROKE, 2005, 36 (12) :165-168
[2]   Stenting versus Aggressive Medical Therapy for Intracranial Arterial Stenosis [J].
Chimowitz, Marc I. ;
Lynn, Michael J. ;
Derdeyn, Colin P. ;
Turan, Tanya N. ;
Fiorella, David ;
Lane, Bethany F. ;
Janis, L. Scott ;
Lutsep, Helmi L. ;
Barnwell, Stanley L. ;
Waters, Michael F. ;
Hoh, Brian L. ;
Hourihane, J. Maurice ;
Levy, Elad I. ;
Alexandrov, Andrei V. ;
Harrigan, Mark R. ;
Chiu, David ;
Klucznik, Richard P. ;
Clark, Joni M. ;
McDougall, Cameron G. ;
Johnson, Mark D. ;
Pride, G. Lee, Jr. ;
Torbey, Michel T. ;
Zaidat, Osama O. ;
Rumboldt, Zoran ;
Cloft, Harry J. .
NEW ENGLAND JOURNAL OF MEDICINE, 2011, 365 (11) :993-1003
[3]   Drug Eluting Stents for Symptomatic Intracranial and Vertebral Artery Stenosis [J].
Fields, J. D. ;
Petersen, B. D. ;
Lutsep, H. L. ;
Nesbit, G. M. ;
Liu, K. C. ;
Dogan, A. ;
Lee, D. S. ;
Clark, W. M. ;
Barnwell, S. L. .
INTERVENTIONAL NEURORADIOLOGY, 2011, 17 (02) :241-247
[4]   Safety, feasibility, and short-term follow-up of drug-eluting stent placement in the intracranial and extracranial circulation [J].
Gupta, Rishi ;
Al-Ali, Firas ;
Thomas, Ajith J. ;
Horowitz, Michael B. ;
Barrow, Thomas ;
Vora, Nirav A. ;
Uchino, Ken ;
Hammer, Maxim D. ;
Wechsler, Lawerence R. ;
Jovin, Tudor G. .
STROKE, 2006, 37 (10) :2562-2566
[5]   Comment on: Stenting versus aggressive medical therapy for intracranial arterial stenosis: Chimowitz MI, Lynn MJ, Derdeyn CP, et al. N Engl J Med. 2011;365:993-1003 [J].
Henkes H. ;
Bäzner H. ;
Nelson P.K. .
Clinical Neuroradiology, 2011, 21 (4) :257-259
[6]   Perforator stroke after elective stenting of symptomatic intracranial stenosis [J].
Jiang, WJ ;
Srivastava, T ;
Gao, F ;
Du, B ;
Dong, KH ;
Xu, XT .
NEUROLOGY, 2006, 66 (12) :1868-1872
[7]   Stenting of symptomatic M1 stenosis of middle cerebral artery - An initial experience of 40 patients [J].
Jiang, WJ ;
Wang, YJ ;
Du, B ;
Wang, SX ;
Wang, GH ;
Jin, M ;
Dai, JP .
STROKE, 2004, 35 (06) :1375-1380
[8]   Predictors of ischemic stroke in the territory of a symptomatic intracranial arterial stenosis [J].
Kasner, SE ;
Chimowitz, MI ;
Lynn, MJ ;
Howlett-Smith, H ;
Stern, BJ ;
Hertzberg, VS ;
Frankel, MR ;
Levine, SR ;
Chaturvedi, S ;
Benesch, CG ;
Sila, CA ;
Jovin, TG ;
Romano, JG ;
Cloft, HJ .
CIRCULATION, 2006, 113 (04) :555-563
[9]  
Kim Kuk Seon, 2012, Neurointervention, V7, P27, DOI 10.5469/neuroint.2012.7.1.27
[10]   Stenting of symptomatic atherosclerotic lesions in the vertebral or intracranial arteries (SSYLVIA) study results [J].
Lutsep, HL ;
Barnwell, S ;
Mawad, M ;
Chiu, D ;
Hartmann, M ;
Hacke, W ;
Reul, JR ;
Biniek, R ;
Guterman, L ;
Yahia, A ;
Weiller, C ;
Zeumer, H ;
Bracard, S ;
Ducrocq, X ;
Dion, J ;
Samuels, O ;
Gomez, CR ;
King, P .
STROKE, 2004, 35 (06) :1388-1392