Early and intermediate-term outcomes with drug-eluting stents in high-risk patients with symptomatic intracranial stenosis.
OBJECTIVE
To report the 1-month and intermediate-term results of treatment of symptomatic intracranial stenosis using drug-eluting stents.


BACKGROUND
Patients with intracranial stenosis who are at high risk because of either high-grade stenosis or medication failure may have an annual risk of recurrent ischemic events in excess of 40%. Drug-eluting stents may reduce the rate of ischemic events in patients with a low restenosis rate.


METHODS
We determined rates of technical success (defined as reduction of target lesion to stenosis <30%) and 1-month major stroke or death in patients with symptomatic intracranial stenosis (> or =70% and/or medication failure). Patients' clinical and follow-up information during a mean period of 14.3 +/- 7 months were obtained. Kaplan-Meier analysis was performed to determine the rate of major stroke-free survival during 12 months.


RESULTS
There were 18 patients (mean age, 58 +/- 16 yr; 12 were men) treated with either a sirolimus-eluting stent (n = 14) or a paclitaxel-eluting stent (n = 4) for stenosis located in the: intracranial internal carotid artery (n = 6), proximal middle cerebral artery (n = 4), intracranial vertebral artery (n = 4), vertebrobasilar junction (n = 2), or basilar artery (n = 2). There was one major stroke and no death observed in the 1-month follow-up. At the 6-month follow-up examination, no major stroke or death was observed. Major stroke-free survival was 86% (+/-standard error of 9%) at 12 months after the procedure. One symptomatic angiographic restenosis was observed during the follow-up period.


CONCLUSIONS
A low rate of major stroke or death was observed after treatment of symptomatic intracranial stenosis using drug-eluting stents in high-risk patients.
Qureshi
Adnan I
AI
Clinical Trials Division, Department of Neurologyand Neurosciences, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA. aiqureshi@hotmail.com
Kirmani
Jawad F
JF
Hussein
Haitham M
HM
Harris-Lane
Pansy
P
Divani
Afshin A
AA
Suri
M Fareed K
MF
Janjua
Nazli
N
Alkawi
Ammar
A
D001807:Blood Vessel Prosthesis; D002544:Cerebral Infarction / Q000209:etiology / Q000517:prevention & control*; D004343:Drug Implants / Q000008:administration & dosage; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000150:complications / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D015607:Stents; D016896:Treatment Outcome
D004343:Drug Implants; D005343:Fibrinolytic Agents