title: Self-expandable stents in the treatment of acute ischemic stroke refractory to current thrombectomy devices.
abstract: OBJECTIVE
  Vessel recanalization is a strong predictor of good outcome in acute ischemic strokes (AIS) secondary to large vessel occlusions. We report our single-center experience with self-expandable stents in the treatment of AIS.
  
  
  METHODS
  The stroke database of Baptist Cardiac and Vascular Institute in Miami was retrospectively reviewed from August of 2008 to September of 2010. All cases of AIS in which a self-expandable stents was deployed as acute endovascular intervention were included in the analysis. Criteria for intervention were the onset of neurological symptoms because of AIS, a National Institute of Health Stroke Scale score ≥4 at presentation, stroke attributable to a large vessel occlusion, and failure of arterial thrombolysis or mechanical thrombectomy or both. Good outcome was defined as a modified Rankin Scale score ≤2 at 1 month from hospital discharge.
  
  
  RESULTS
  Nineteen patients with AIS who underwent stenting were identified. Median National Institute of Health Stroke Scale score on admission was 19. Six Enterprise and 13 Wingspan stents were deployed. Recanalization was achieved in 95% occlusions (63% thrombolysis in myocardial infarction grade 3 and 32% thrombolysis in myocardial infarction grade 2). Good clinical outcome was achieved in 42%. No intraprocedural complications occurred and all stents were successfully deployed. Symptomatic intracerebral hemorrhage occurred in 3 (16%) patients, 2 of whom died.
  
  
  CONCLUSIONS
  Use of self-expandable stents in AIS appears to be safe and may be considered when currently available thrombectomy devices and/or intraarterial thrombolysis fail.
authors: Baptist Cardiac and Vascular Institute, 8900 N Kendall Drive, Miami, FL 33176, USA. italol@baptisthealth.net
authors: Italo
authors: I
authors: Linfante
authors: Edgar A
authors: EA
authors: Samaniego
authors: Philipp
authors: P
authors: Geisbüsch
authors: Guilherme
authors: G
authors: Dabus
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000209:etiology*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D015607:Stents; D020521:Stroke / Q000209:etiology*; D015912:Thrombolytic Therapy