The use of balloon-expandable stents in the management of intracranial arterial diseases: a 5-year single-center experience.

Abstract

BACKGROUND AND PURPOSE:

Although stent-assisted intracranial procedures are becoming a routine clinical practice, there have been relatively few large studies published in the literature regarding the application of the balloon-expandable stent technology in the treatment of intracranial arterial diseases. In this report, the authors reviewed their experience with 75 cases at a single center.

METHODS:

From 1998 to 2003, 75 patients underwent percutaneous transluminal intracranial stent placement as a treatment for wide-necked intracranial aneurysms and atherosclerotic stenoses. The anatomy of the target lesions, technical details of the procedures, device functionality, procedure-related complications, and short-term outcomes were reviewed in a retrospective fashion.

RESULTS:

The clinical indications included wide-necked intracranial aneurysms (59) and atherosclerotic stenoses (16). The stent was successfully deployed in 92% of the patients (69 of 75 cases). In the remaining 6 cases, the causes of failed stent deployment included arterial tortuosities (2), stent migration (2), fracture of the stent (1), and arterial perforation (1). The short-term outcome (mean follow-up, 7.5 months; range, 3-12 months) was evaluated by using the modified Rankin scale (MR spectroscopy 0-6). Fifty-three patients (70.6%) had excellent outcomes (MR spectroscopy 0-1), 12 (16%) had good outcomes (MR spectroscopy 2), and 5 (6.7%) had poor outcomes (MR spectroscopy 4-5). Five patients (6.7%) died.

CONCLUSION:

The use of BES is associated with a high rate of hemorrhagic and ischemic complications, more specifically when used in the anterior circulation. Cases of large-necked aneurysms not treatable with balloon remodeling technique and atheromatous sclerosis could be eligible for this treatment.

• Authors: Iruena Moraes Kessler, Charbel Mounayer, Michel Piotin, Laurent Spelle, Jose Ricardo Vanzin, Jacques Moret
• Journal: AJNR. American journal of neuroradiology (AJNR Am J Neuroradiol) Vol. 26 Issue 9 Pg. 2342-8 (Oct 2005) ISSN: 0195-6108 [Print] United States
• PMID: 16219843 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Angioplasty, Balloon (adverse effects)
• Cerebral Angiography
• Child
• Equipment Failure
• Female
• Humans
• Intracranial Aneurysm (diagnostic imaging, pathology, therapy)
• Intracranial Arteriosclerosis (diagnostic imaging, therapy)
• Male
• Middle Aged
• Stents (adverse effects)