Stent Placement in Acute Cerebral Artery Occlusion
- 1 March 2009
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 40 (3), 847-852
- https://doi.org/10.1161/strokeaha.108.533810
Abstract
Background and Purpose— Stent placement has been applied in small case series as a rescue therapy in combination with different thrombolytic agents, percutaneous balloon angioplasty (PTA), and mechanical thromboembolectomy (MT) in acute stroke treatment. These studies report a considerable mortality and a high rate of intracranial hemorrhages when balloon-mounted stents were used. This study was performed to evaluate feasibility, efficacy, and safety of intracranial artery recanalization for acute ischemic stroke using a self-expandable stent. Methods— All patients treated with an intracranial stent for acute cerebral artery occlusion were included. Treatment comprised intraarterial thrombolysis, thromboaspiration, MT, PTA, and stent placement. Recanalization result was assessed by follow-up angiography immediately after stent placement. Complications related to the procedure and outcome at 3 months were assessed. Results— Twelve patients (median NIHSS 14, mean age 63 years) were treated with intracranial stents for acute ischemic stroke. Occlusions were located in the posterior vertebrobasilar circulation (n=6) and in the anterior circulation (n=6). Stent placement was feasible in all procedures and resulted in partial or complete recanalization (TIMI 2/3) in 92%. No vessel perforations, subarachnoid, or symptomatic intracerebral hemorrhages occurred. One dissection was found after thromboaspiration and PTA. Three patients (25%) had a good outcome (mRS 0 to 2), 3 (25%) a moderate outcome (mRS 3), and 6 (50%) a poor outcome (mRS 4 to 6). Mortality was 33.3%. Conclusions— Intracranial placement of a self-expandable stent for acute ischemic stroke is feasible and seems to be safe to achieve sufficient recanalization.Keywords
This publication has 24 references indexed in Scilit:
- Mechanical Thrombectomy for Acute Ischemic StrokeStroke, 2008
- Emergency Administration of Abciximab for Treatment of Patients With Acute Ischemic Stroke: Results of an International Phase III TrialStroke, 2008
- The Impact of Recanalization on Ischemic Stroke OutcomeStroke, 2007
- Symptomatic intracranial haemorrhage after intra-arterial thrombolysis in acute ischaemic stroke: assessment of 294 patients treated with urokinaseJournal of Neurology, Neurosurgery & Psychiatry, 2006
- Multimodal Reperfusion Therapy for Acute Ischemic StrokeStroke, 2006
- Safety and Efficacy of Mechanical Embolectomy in Acute Ischemic StrokeStroke, 2005
- Clinical and radiological predictors of recanalisation and outcome of 40 patients with acute basilar artery occlusion treated with intra-arterial thrombolysisJournal of Neurology, Neurosurgery & Psychiatry, 2004
- Trial Design and Reporting Standards for Intra-Arterial Cerebral Thrombolysis for Acute Ischemic StrokeStroke, 2003
- Direct Percutaneous Transluminal Angioplasty for Acute Middle Cerebral Artery Trunk OcclusionStroke, 2002
- The Thrombolysis in Myocardial Infarction (TIMI) TrialNew England Journal of Medicine, 1985