Early and intermediate-term outcomes with drug-eluting stents in high-risk patients with symptomatic intracranial stenosis

Neurosurgery. 2006 Nov;59(5):1044-51; discussion 1051. doi: 10.1227/01.NEU.0000245593.54204.99.


Objective: To report the 1-month and intermediate-term results of treatment of symptomatic intracranial stenosis using drug-eluting stents.

Background: Patients with intracranial stenosis who are at high risk because of either high-grade stenosis or medication failure may have an annual risk of recurrent ischemic events in excess of 40%. Drug-eluting stents may reduce the rate of ischemic events in patients with a low restenosis rate.

Methods: We determined rates of technical success (defined as reduction of target lesion to stenosis <30%) and 1-month major stroke or death in patients with symptomatic intracranial stenosis (> or =70% and/or medication failure). Patients' clinical and follow-up information during a mean period of 14.3 +/- 7 months were obtained. Kaplan-Meier analysis was performed to determine the rate of major stroke-free survival during 12 months.

Results: There were 18 patients (mean age, 58 +/- 16 yr; 12 were men) treated with either a sirolimus-eluting stent (n = 14) or a paclitaxel-eluting stent (n = 4) for stenosis located in the: intracranial internal carotid artery (n = 6), proximal middle cerebral artery (n = 4), intracranial vertebral artery (n = 4), vertebrobasilar junction (n = 2), or basilar artery (n = 2). There was one major stroke and no death observed in the 1-month follow-up. At the 6-month follow-up examination, no major stroke or death was observed. Major stroke-free survival was 86% (+/-standard error of 9%) at 12 months after the procedure. One symptomatic angiographic restenosis was observed during the follow-up period.

Conclusion: A low rate of major stroke or death was observed after treatment of symptomatic intracranial stenosis using drug-eluting stents in high-risk patients.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Blood Vessel Prosthesis*
  • Cerebral Infarction / etiology
  • Cerebral Infarction / prevention & control*
  • Drug Implants / administration & dosage
  • Female
  • Fibrinolytic Agents / administration & dosage*
  • Humans
  • Intracranial Arteriosclerosis / complications
  • Intracranial Arteriosclerosis / surgery*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Risk Assessment
  • Stents*
  • Treatment Outcome


  • Drug Implants
  • Fibrinolytic Agents