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

Neurol Res. 2005;27 Suppl 1:S84-8. doi: 10.1179/016164105X35495.

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.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon
  • Cerebral Angiography
  • Humans
  • Intracranial Arteriosclerosis / diagnostic imaging
  • Intracranial Arteriosclerosis / surgery*
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Stents*
  • Treatment Outcome