Safety, feasibility, and short-term follow-up of drug-eluting stent placement in the intracranial and extracranial circulation.

Abstract:

BACKGROUND AND PURPOSE:The use of bare metal stents to treat symptomatic intracranial stenosis may be associated with significant restenosis rates. The advent of drug-eluting stents (DESs) in the coronary circulation has resulted in a reduction of restenosis rates. We report our technical success rate and short-term restenosis rates after stenting with DESs in the intracranial and extracranial circulation. METHODS:This study was a retrospective review of the period between April 1, 2004, and April 15, 2006, of 59 patients with 62 symptomatic intracranial or extracranial atherosclerotic lesions at 2 medical centers (University of Pittsburgh and Borgess Medical Center). RESULTS:The mean age of our cohort was 61+/-12 years. The location of the 62 lesions was as follows: extracranial vertebral artery 31 (50%), intracranial vertebral artery or basilar artery 18 (29%), extracranial internal carotid artery (ICA) near the petrous bone 5 (8%), and intracranial ICA 8 (13%). There were 2 (3%) periprocedural complications: 1 non-flow-limiting dissection and 1 disabling stroke. Fifty vessels were available for follow-up angiography or computed tomography angiography at a median time of 4.0+/-2 months. A total of 2 of 36 extracranial stents (7%) and 1 of 26 intracranial stents (5%) were found to have restenosis > or = 50% at follow-up. CONCLUSIONS:This report demonstrates that DES delivery in the intracranial and extracranial circulation is technically feasible. A small percentage of patients developed short-term in-stent restenosis. Longer-term follow-up is required in the setting of a prospective study to determine the late restenosis rates for DESs in comparison with bare metal stents.

journal_name

Stroke

journal_title

Stroke

authors

Gupta R,Al-Ali F,Thomas AJ,Horowitz MB,Barrow T,Vora NA,Uchino K,Hammer MD,Wechsler LR,Jovin TG

doi

10.1161/01.STR.0000242481.38262.7b

subject

Has Abstract

pub_date

2006-10-01 00:00:00

pages

2562-6

issue

10

eissn

0039-2499

issn

1524-4628

pii

01.STR.0000242481.38262.7b

journal_volume

37

pub_type

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