title: Drug eluting stents for symptomatic intracranial and vertebral artery stenosis.
abstract: The use of bare metal stents (BMS) to prevent recurrent stroke due to stenosis of the cerebral vasculature is associated with high rates of restenosis. Drug-eluting stents (DES) may decrease this risk. We evaluated the performance of DES in a cohort of patients treated at our institution.Consecutive patients treated with DES were identified by a case log and billing records; data regarding procedural details, clinical outcome and angiographic follow-up was obtained by retrospective chart review.Twenty-six patients (27 vessels; 14 vertebral origin (VO); 13 intracranial) were treated. Stenosis was reduced from mean 81% to 8% at the VO and 80% to 2% intracranially. No strokes occurred in the first 24 hours after stenting or at any time point in the VO group during a mean follow-up period of nine months. Among patients with intracranial stents, stroke with permanent disability occurred within 30 days in 1/12 (8%) and after 30 days in 1/11 (9%) with clinical follow-up (mean follow-up, 14 months). Follow-up catheter angiography was obtained in 14/14 (100%) in the VO group at mean eight months and in 8/11 surviving patients (73%) at a mean of ten months after stenting in the intracranial group. The restenosis rate was 21% at the VO (3/14) and 38% (3/8) for intracranial stents. Restenosis at the VO was less frequent than might have been expected from reports utilizing BMS, however, overall restenosis rates appeared higher than previously reported for patients with intracranial DES and comparable with restenosis rates for intracranial BMS.
authors.affiliation: Interventional Neuroradiology, Department of Neurology Oregon Health & Science University, Portland, USA. fieldsje@ohsu.edu
authors.forename: J D
authors.initials: JD
authors.lastname: Fields
authors.forename: B D
authors.initials: BD
authors.lastname: Petersen
authors.forename: H L
authors.initials: HL
authors.lastname: Lutsep
authors.forename: G M
authors.initials: GM
authors.lastname: Nesbit
authors.forename: K C
authors.initials: KC
authors.lastname: Liu
authors.forename: A
authors.initials: A
authors.lastname: Dogan
authors.forename: D S
authors.initials: DS
authors.lastname: Lee
authors.forename: W M
authors.initials: WM
authors.lastname: Clark
authors.forename: S L
authors.initials: SL
authors.lastname: Barnwell
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000379:methods* / Q000706:statistics & numerical data; D002548:Cerebral Revascularization / Q000379:methods / Q000706:statistics & numerical data; D054855:Drug-Eluting Stents / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D012307:Risk Factors; D055502:Secondary Prevention; D020521:Stroke / Q000453:epidemiology / Q000517:prevention & control*; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000453:epidemiology / Q000628:therapy*