title: Safety, feasibility, and short-term follow-up of drug-eluting stent placement in the intracranial and extracranial circulation.
abstract: OBJECTIVE
  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 > or = 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.
authors.affiliation: Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
authors.forename: Rishi
authors.initials: R
authors.lastname: Gupta
authors.forename: Firas
authors.initials: F
authors.lastname: Al-Ali
authors.forename: Ajith J
authors.initials: AJ
authors.lastname: Thomas
authors.forename: Michael B
authors.initials: MB
authors.lastname: Horowitz
authors.forename: Thomas
authors.initials: T
authors.lastname: Barrow
authors.forename: Nirav A
authors.initials: NA
authors.lastname: Vora
authors.forename: Ken
authors.initials: K
authors.lastname: Uchino
authors.forename: Maxim D
authors.initials: MD
authors.lastname: Hammer
authors.forename: Lawerence R
authors.initials: LR
authors.lastname: Wechsler
authors.forename: Tudor G
authors.initials: TG
authors.lastname: Jovin
mesh_terms: D000784:Aortic Dissection / Q000209:etiology; D000925:Anticoagulants / Q000627:therapeutic use; D002114:Calcinosis / Q000628:therapy; D002342:Carotid Artery, External; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000517:prevention & control / Q000628:therapy*; D002404:Catheterization; D015331:Cohort Studies; D004341:Drug Evaluation; D004343:Drug Implants; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000188:drug therapy / Q000517:prevention & control / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009928:Organ Specificity; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012008:Recurrence; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015607:Stents / Q000009:adverse effects / Q000706:statistics & numerical data*; D020521:Stroke / Q000209:etiology; D014715:Vertebrobasilar Insufficiency / Q000517:prevention & control / Q000628:therapy*
chemical_list: D000925:Anticoagulants; D004343:Drug Implants; D017239:Paclitaxel; D020123:Sirolimus