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


CONCLUSIONS
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.
Kessler
Iruena Moraes
IM
Department of Interventional Neuroradiology, Fondation Rothschild, Paris, France.
Mounayer
Charbel
C
Piotin
Michel
M
Spelle
Laurent
L
Vanzin
Jose Ricardo
JR
Moret
Jacques
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects; D002533:Cerebral Angiography; D002648:Child; D004868:Equipment Failure; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015607:Stents / Q000009:adverse effects