Stenting for the treatment of high-grade intracranial stenoses
- Resource Type
- Authors
- R. Papa; Silvia Lanfranconi; Livia Candelise; M. Isalberti; E. Ballabio; Anna Bersano; V. Branca
- Source
- Journal of Neurology. 257:1899-1908
- Subject
- Male
medicine.medical_specialty
Percutaneous
medicine.medical_treatment
Constriction, Pathologic
Postoperative Complications
Angioplasty
Humans
Medicine
cardiovascular diseases
Stroke
Aged
Retrospective Studies
business.industry
Vascular disease
Stent
Middle Aged
Intracranial Arteriosclerosis
medicine.disease
Surgery
Stenosis
Dissection
Treatment Outcome
Neurology
Female
Stents
Neurology (clinical)
Radiology
Complication
business
Vascular Surgical Procedures
- Language
- ISSN
- 1432-1459
0340-5354
To date, evidence to recommend endovascular treatment in patients with intracranial stenoses is lacking. Recently, the introduction of self-expanding stents (Wingspan Stent System) aroused considerable expectations in their employ for stroke prevention. We report a single-center experience of percutaneous transluminal angioplasty and stenting in a series of consecutive patients with intracranial stenoses and compare the safety and performance of balloon-mounted stents versus self-expanding stent systems (Wingspan). Thirty-four patients with 39 severe (>70%) intracranial stenoses were treated during a 6-year period. An independent stroke neurologist collected data about intra and periprocedural complications and short-term outcome. We considered as endpoint measures (1) any 30-day stroke or death (2) any major 30-day complication and (3) procedure technical success. Technical success was achieved in all patients. No vessel dissection or ruptures were observed. The 30-day stroke/death rate was 17.9%. Five ischemic strokes in the territory of treated vessels and two intracranial hemorrhages occurred respectively within 24 h and 5 days after endovascular treatment. Three (17.6%) patients of Wingspan treated group and four (18.2%) of the patients treated with different stent systems had unfavorable outcome. Our study confirms that endovascular treatment can be performed with a high technical success rate, even though the safety of these devices has still to be demonstrated.