[Stent for neurovascular diseases].
A stent is a medical device that can provide scaffolding to vessels and organ walls to keep the arteries open. Different types of stents have been used in the filed of neurovascular diseases, such as atherosclerosis and aneurysms. Carotid artery stenting (CAS) was approved in 2007 in Japan, and it has been widely used as an alternative to carotid endarterectomy (CEA) for treating severe carotid artery stenosis. According to current approval, the indications of carotid artery stenting are observed in high-surgical-risk patients, patients with more than 50% symptomatic stenosis, and those with more than 80% asymptomatic stenosis. The use of nickel-titanium (nitinol) crush-resistant self-expanding stents (Precise) and emblic-protection devices (Angioguard XP) has been approved. Intracranial atherosclerotic disease have frequently posed a risk for recurrent stroke despite the intensive medical treatment. The design of the Wingspan stent system is different from that of balloon-expandable stents. Target lesions are predilated with an undersized angioplasty balloon, followed by stent deployment. Another important indication is for intracranial aneurysms. Since the discovery Guglielmi dechatable coils (GDC) in the early 1990s, endovascular treatment has been drastically improved all over the world. However, a high recurrence rate is observed when large and wide-necked aneurysms are treated with detachble coils. The application of self-expanding stents such as Neuroform, Enterprize, or LEO, is effective for packing coils into the aneurysm, and flow modification effect can be achieved for the curative reconstruction of the parent arteries. Further reserch will confirm the application of stents for the treatment of cerebrovascular disease.
Neurosurgery and KCGH Stroke Center, Kobe City General Hospital, 4-6 Minatojima Nakamachi, Chuo-ku, Kobe-shi, Hyogo 650-0046, Japan.
Nobuyuki
N
Sakai
Chiaki
C
Sakai
D000783:Aneurysm / Q000628:therapy*; D000800:Angioplasty, Balloon; D050197:Atherosclerosis / Q000628:therapy*; D002339:Carotid Arteries; D016893:Carotid Stenosis / Q000628:therapy; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy; D015607:Stents; D020521:Stroke / Q000209:etiology / Q000517:prevention & control