Primary stent therapy for symptomatic intracranial atherosclerotic stenosis: 1-year follow-up angiographic and midterm clinical outcomes.
OBJECTIVE
The aim of this study was to report 1-year angiographic follow-up results and midterm clinical outcomes in patients with symptomatic intracranial atherosclerotic lesions treated with stent placement.


METHODS
Ten patients with ischemic symptoms referable to stenotic intracranial atherosclerotic arteries, with greater than 60% stenosis, underwent elective surgery in which a primary stent was placed. All patients underwent pretreatment (> or =1 week) combination oral antiplatelet (clopidogrel and aspirin) therapy and long-term (6-month) combination oral antiplatelet (clopidogrel and aspirin) therapy after stents were placed. The procedure involved selecting stents of the same size as the diameter of the target vessel and slowly inflating the balloon to its nominal pressure. One-year angiography and midterm clinical follow-up data were obtained. The stents were successfully placed in all patients without any perioperative complication. The mean preoperative stenosis rate of 81% decreased to 4% after the stent was placed. Nine patients who underwent follow-up angiography (one patient refused) at a mean of 12.3 months (range 10-19 months) had no changes in luminal diameter compared with the immediate postoperative luminal diameter. Luminal narrowing increased, from 15 to 38%, in one case in which there was comparatively greater residual stenosis (15%). No patient suffered new ischemic symptoms during a mean clinical follow-up period of 21 months (range 12-36 months).


CONCLUSIONS
Elective stent surgery can provide good angiographic and clinical midterm outcomes in patients with symptomatic intracranial atherosclerotic stenosis, and the procedure is associated with a high degree of technical success. Reassessment of these promising results is needed in a larger population and in a randomized prospective comparison study.
Lee
Chang-Young
CY
Department of Neurosurgery, Brain Research Institute, Keimyung University School of Medicine, Daegu, South Korea. nslcy@dsmc.or.kr
Yim
Man-Bin
MB
D000328:Adult; D000368:Aged; D001241:Aspirin / Q000008:administration & dosage; D002533:Cerebral Angiography; D000077144:Clopidogrel; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D015607:Stents; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin