Intracranial arterial stenting for symptomatic stenoses: a Latin American experience.

Abstract

BACKGROUND:

The proportionally higher incidence of intracranial atherosclerosis among Asian and black patients and a greater proclivity for intracranial artery stenosis in the Hispanic population merit drawing attention to a Latin American experience with intracranial arterial stenting.

METHODS:

This is a retrospective analysis of an observational study of 33 intracranial lesions (each >50% stenosis) in 32 patients treated by intracranial angioplasty in 6 Latin American centers over a 3-year period. The investigation used a unique device, a balloon-expandable stent (Lekton Motion stent system, now Pharos, Biotronik, AG, Bülach, Switzerland).

RESULTS:

The treated patients ranged in age from 30 to 81 years (mean, 59.3 years; SD, 12 years), including 24 male and 8 female patients (sex ratio, 4:1). Two were Asians, 4 were blacks, and the rest were white Hispanic. Our mean follow-up is of 10.2 months (SD, 7.84 months), with a mortality rate of 9.4% (3/32), a nonfatal complication rate of 6.2%, and a stroke rate (rate of recurrence) of 0%. The mean pretreatment stenosis of 68.75% (SD, 14%) was reduced to a residual of 5.16% (SD, 16%) (P = .000; 95% confidence interval, 56.8%-70.3%). A control angiogram was performed in 82% of patients, and in that case, the restenosis 50% or greater was of 8.7% during the follow-up period.

CONCLUSION:

The treatment of intracranial stenosis with the Lekton Motion stent (Pharos) is feasible with a high technical success rate. Restenosis as well as the rate of new neurologic events during follow-up suggests some efficacy of stroke prevention by using the latest-generation, highly trackable, balloon-expandable stents.

• Authors: José Maria Modenesi Freitas, Marco Zenteno, Yolanda Aburto-Murrieta, Gelson Koppe, Carlos Abath, José Aldemir Nunes, Eduardo Raupp, Raquel Hidalgo, Marco Antonio Pieruccetti, Angel Lee
• Journal: Surgical neurology (Surg Neurol) Vol. 68 Issue 4 Pg. 378-86 (Oct 2007) ISSN: 0090-3019 [Print] United States
• PMID: 17905061 (Publication Type: Clinical Trial, Journal Article, Multicenter Study)

Chemical References

• Anticoagulants

Topics

• Adult
• Aged
• Aged, 80 and over
• Angioplasty
• Anticoagulants (therapeutic use)
• Atherosclerosis (complications)
• Cerebral Angiography
• Cerebral Arterial Diseases (etiology, mortality, surgery)
• Constriction, Pathologic
• Endpoint Determination
• Female
• Follow-Up Studies
• Humans
• Latin America
• Male
• Middle Aged
• Neurosurgical Procedures
• Postoperative Complications (epidemiology, therapy)
• Preoperative Care
• Recurrence
• Retrospective Studies
• Stents