title: Complication rates using balloon-expandable and self-expanding stents for the treatment of intracranial atherosclerotic stenoses : analysis of the INTRASTENT multicentric registry.
abstract: BACKGROUND
  Using balloon-expandable stents (BES) for treatment of intracranial stenoses, high inflation pressures and rigidity of the device are regarded as major drawbacks limiting feasibility and safety of the procedure. Self-expanding stents (SES) were developed to facilitate lesion access and to allow for less aggressive dilatation. We analyzed data of the INTRASTENT multicentric registry to assess whether self-expanding stents significantly reduced peri-interventional complication rates.
  
  
  METHODS
  Records of intracranial stent procedures were entered consecutively into the registry. Datasets were divided into two groups according to the type of stent used. For outcome measurement, we chose three categories: TIA/minor stroke [modified Rankin score (mRS) <2], disabling stroke, and patient death. Clinical outcome was compared between BES and SES. We analyzed types of adverse events occurring in each group in addition.
  
  
  RESULTS
  Of 409 atherosclerotic lesions, 254 were treated with BES and 155 with SES. Technical success rates were 97.6% and 98.7%, respectively. Adverse event rates were 4.9%, 3.7%, and 0.8% for TIA/nondisabling stroke, disabling stroke, and death in the BES group compared with 5.3%, 6.0%, and 4.0% in the SES group. The differences were not statistically significant. We observed more perforator strokes after use of BES, but thromboembolic events occurred more often in the SES treatment group.
  
  
  CONCLUSIONS
  Data of the INTRASTENT registry do not support the hypothesis that introduction of SES lowered the overall complication rate of intracranial stent procedures. There might be an advantage using self-expanding stents in vessel segments with important perforating arteries.
authors.affiliation: Department of Neuroradiology, Alfried Krupp Krankenhaus, Alfried Krupp Strasse 21, 45131, Essen, Germany. wiebke.kurre@krupp-krankenhaus.de
authors.forename: Wiebke
authors.initials: W
authors.lastname: Kurre
authors.forename: Friedhelm
authors.initials: F
authors.lastname: Brassel
authors.forename: Roland
authors.initials: R
authors.lastname: Brüning
authors.forename: Jan
authors.initials: J
authors.lastname: Buhk
authors.forename: Bernd
authors.initials: B
authors.lastname: Eckert
authors.forename: Susanna
authors.initials: S
authors.lastname: Horner
authors.forename: Michael
authors.initials: M
authors.lastname: Knauth
authors.forename: Thomas
authors.initials: T
authors.lastname: Liebig
authors.forename: Jana
authors.initials: J
authors.lastname: Maskova
authors.forename: Dirk
authors.initials: D
authors.lastname: Mucha
authors.forename: Vojtech
authors.initials: V
authors.lastname: Sychra
authors.forename: Matthias
authors.initials: M
authors.lastname: Sitzer
authors.forename: Michael
authors.initials: M
authors.lastname: Sonnberger
authors.forename: Marc
authors.initials: M
authors.lastname: Tietke
authors.forename: Johannes
authors.initials: J
authors.lastname: Trenkler
authors.forename: Bernd
authors.initials: B
authors.lastname: Turowski
authors.forename: Joachim
authors.initials: J
authors.lastname: Berkefeld
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000009:adverse effects*; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012042:Registries; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome