title: Solving the Issue of Restenosis After Stenting of Intracranial Stenoses: Experience with Two Thin-Strut Drug-Eluting Stents (DES)-Taxus Element™ and Resolute Integrity™.
abstract: OBJECTIVE
  Thin-strut, flexible DES are suitable for intracranial stenting and may improve long-term vessel patency. The purpose of this study was to report our experience with two new-generation DES for the treatment of intracranial atherosclerotic disease.
  
  
  METHODS
  We retrospectively reviewed all patients treated with Taxus Element™ or Resolute Integrity™ stent for an intracranial atherosclerotic stenosis between March 2011 and August 2013. Technical success was defined as the ability to deploy the device at the desired location and reduce the degree of stenosis below 50 %. All procedure-related strokes were recorded. Control angiography was scheduled after 6 weeks, 3, 6, and 12 months and yearly thereafter. A luminal narrowing ≥50 % was regarded as a restenosis. Stroke recurrence in the territory of the treated artery was reported.
  
  
  RESULTS
  In the defined period we treated 101 patients harboring 117 intracranial stenoses. The procedure was successful in 100 (85.5 %) lesions. Procedure-related strokes occurred in 10 (9.9 %) patients with a permanent morbidity in 3 (3.0 %). Follow-up angiography was available for 83 of 100 (83.0 %) successfully treated lesions with an average of 355 days (IQR 153-482 days). Three (3.6 %) asymptomatic restenoses were detected. All occurred after treatment with Resolute Integrity™, none after Taxus Element™ (p = 0.059). New strokes in the territory of the treated artery were encountered in 2 (2.6 %) occasions.
  
  
  CONCLUSIONS
  Thin-strut DES improve long-term patency and reduce the risk of subsequent stroke. Differences between devices may exist. Feasibility is comparable to bare-metal balloon-mounted stents and procedure-related strokes occurred within the expected range.
authors.affiliation: Klinik für Diagnostische und Interventionelle Neuroradiologie, Klinikum Stuttgart, Kriegsbergstrasse 60, 70174, Stuttgart, Germany, wiebke.kurre@gmx.de.
authors.forename: Wiebke
authors.initials: W
authors.lastname: Kurre
authors.forename: Marta
authors.initials: M
authors.lastname: Aguilar-Pérez
authors.forename: Sebastian
authors.initials: S
authors.lastname: Fischer
authors.forename: Guy
authors.initials: G
authors.lastname: Arnold
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Schmid
authors.forename: Hansjörg
authors.initials: H
authors.lastname: Bäzner
authors.forename: Hans
authors.initials: H
authors.lastname: Henkes
mesh_terms: D000368:Aged; D054855:Drug-Eluting Stents; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000517:prevention & control*; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D012008:Recurrence; D012189:Retrospective Studies; D020521:Stroke / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D017239:Paclitaxel