Use of the enterprise™ intracranial stent for revascularization of large vessel occlusions in acute stroke.
OBJECTIVE
Major cerebral thromboembolism often resists recanalization with currently available techniques. The authors present their initial experience with a self-expanding stent for use in intracranial vascular reconstruction, permitting immediate recanalization of acute thromboembolic occlusions of the anterior circulation.


METHODS
Patients treated with the Cordis Enterprise™ self-expanding intracranial stent system for acute thromboembolic occlusion of the major anterior cerebral arteries were included. Treatment comprised systemic and intraarterial thrombolysis, mechanical thrombectomy, and stent placement. Stent deployment, recanalization rate by means of Thrombolysis In Cerebral Infarction (TICI) scores and the clinical outcome were all assessed.


RESULTS
Six patients presenting with acute carotid T (n = 2) or proximal middle cerebral artery occlusion (n = 4) were treated. The mean National Institutes of Health Stroke Scale (NIHSS) score at presentation was 14; the mean age was 57 years. Successful stent deployment and immediate recanalization were achieved in all six with a TICI score of ≥ 2. Neither distal emboli nor any procedure-related complications were encountered. One patient developed symptomatic intracerebral hemorrhage and two patients needed decompressive craniectomy after treatment. The mean NIHSS score at 10 days was 10, but only one patient showed a complete recovery at 3 months.


CONCLUSIONS
Intracranial placement of the Enterprise™ self-expanding stent has proven to be feasible and efficient in achieving immediate recanalization of occluded main cerebral arteries. The use of antiplatelet therapy after treatment may, however, increase the risk of reperfusion intracerebral hemorrhage.
Neurointerventional Division, Geneva University Hospital, Geneva, Switzerland, kulcsarzsolt22@gmail.com.
Zsolt
Z
Kulcsár
Christophe
C
Bonvin
Karl-Olof
KO
Lovblad
Benjamin
B
Gory
Hasan
H
Yilmaz
Roman
R
Sztajzel
Daniel
D
Rufenacht
D000328:Adult; D000368:Aged; D001807:Blood Vessel Prosthesis; D002539:Cerebral Arterial Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D002548:Cerebral Revascularization / Q000295:instrumentation* / Q000379:methods; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011859:Radiography; D015607:Stents; D020521:Stroke / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome