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

R Gupta, F Al-Ali, AJ Thomas, MB Horowitz, T Barrow… - Stroke, 2006 - Am Heart Assoc
R Gupta, F Al-Ali, AJ Thomas, MB Horowitz, T Barrow, NA Vora, K Uchino, MD Hammer…
Stroke, 2006Am Heart Assoc
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 …
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 ≥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.
Am Heart Assoc
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