title: Treatment of acute ischemic stroke: feasibility of primary or secondary use of a self-expanding stent (Neuroform) during local intra-arterial thrombolysis.
abstract: BACKGROUND
  We evaluated the feasibility of employing a self-expanding stent (Neuroform) in treatment of acute cerebral ischemia and compared the results of primary and secondary stenting.
  
  
  METHODS
  We analyzed the treatment results of 14 acute ischemic stroke patients (11 men and three women; median age, 65 years) who were treated with Neuroform stents. Seven patients received stent placement for primary recanalization and a further seven for secondary recanalization. We performed between-group comparisons of all of overall procedure duration, recanalization rate immediately after stenting, need for additional measures after stenting, final recanalization rate, occurrence of hemorrhagic transformation, early re-occlusion rate after 24 h, and 3-month functional recovery rate (mRS ≤2).
  
  
  RESULTS
  The median interval from femoral puncture to stent placement was 61.5 min and was significantly shorter in the primary than in the secondary group (55 vs. 95 min, p = 0.004). The recanalization rate immediately after stenting was 42.9% and was greater in the primary than in the secondary group (71.4% vs. 14.3%, p = 0.1). Thirteen patients required various additional therapeutic measures. The final recanalization rate was 78.6%, attributable to improvements in the recanalization rate of the secondary group (71.4% vs. 85.7%). Early hemorrhagic transformation was noted in four patients, but only one patient became symptomatic (symptomatic hemorrhage, 7.1%). Good functional recovery was noted in eight patients (57.1%).
  
  
  CONCLUSIONS
  Placement of a self-expanding stent during endovascular recanalization of acute ischemic stroke was both feasible and safe. Primary use of this method may enhance early recanalization.
authors.affiliation: Department of Radiology, East-West Neo Medical Center, Kyung Hee University, Seoul, South Korea.
authors.forename: Sun Mi
authors.initials: SM
authors.lastname: Kim
authors.forename: Deok Hee
authors.initials: DH
authors.lastname: Lee
authors.forename: Sun Uck
authors.initials: SU
authors.lastname: Kwon
authors.forename: Choong Gon
authors.initials: CG
authors.lastname: Choi
authors.forename: Sang Joon
authors.initials: SJ
authors.lastname: Kim
authors.forename: Dae Chul
authors.initials: DC
authors.lastname: Suh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000628:therapy*; D002533:Cerebral Angiography; D003131:Combined Modality Therapy; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D015607:Stents; D020521:Stroke / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents