Urgent Recanalization with Stenting for Severe Intracranial Atherosclerosis after Transient Ischemic Attack or Minor Stroke.
10.3340/jkns.2011.50.4.322
- Author:
Tae Sik PARK
1
;
Beom Jin CHOI
;
Tae Hong LEE
;
Joon Suk SONG
;
Dong Youl LEE
;
Sang Min SUNG
Author Information
1. Department of Neurosurgery, Wallace Memorial Baptist Hospital, Busan, Korea.
- Publication Type:Original Article
- Keywords:
Acute ischemic stroke;
Transient ischemic attack;
Intracranial atherosclerosis;
Intracranial stenting
- MeSH:
Angiography;
Angioplasty;
Antibodies, Monoclonal;
Arteries;
Constriction, Pathologic;
Dissent and Disputes;
Follow-Up Studies;
Humans;
Immunoglobulin Fab Fragments;
Intracranial Arteriosclerosis;
Ischemic Attack, Transient;
Phenobarbital;
Retrospective Studies;
Stents;
Stroke;
Thrombosis
- From:Journal of Korean Neurosurgical Society
2011;50(4):322-326
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Stenting of symptomatic intracranial stenosis has recently become an alternative treatment modality. However, urgent intracranial stenting in patients with intracranial stenosis following a transient ischemic attack (TIA) or minor stroke is open to dispute. We sought to assess the feasibility, safety, and effectiveness of urgent intracranial stenting for severe stenosis (>70%) in TIA or minor stroke patients. METHODS: Between June 2009 and October 2010, stent-assisted angioplasty by using a balloon-expandable coronary stent for intracranial severe stenosis (>70%) was performed in 7 patients after TIA and 5 patients after minor stroke (14 stenotic lesions). Technical success rates, complications, angiographic findings, and clinical outcomes were retrospectively analyzed. RESULTS: Stenting was successful in all 12 patients. The mean time from symptom onset to stenting was 2.1 days (1-8 days). Post-procedural angiography showed restoration to a normal luminal diameter in all patients. In-stent thrombosis occurred in one patient (n=1, 8.3%), and was lysed with abciximab. No device-related complications, such as perforations or dissections at the target arteries or intracranial hemorrhaging, occurred in any patient. The mortality rate was 0%. No patient had an ischemic event over the mean follow-up period of 12.5 months (range, 7-21 months), and follow-up angiography (n=7) revealed no significant in-stent restenosis (>50%). CONCLUSION: Urgent recanalization with stenting is feasible, safe, and effective in patients with TIA or acute minor stroke with intracranial stenosis of > or =70%.
