title: Intracranial Stenting as a Rescue Therapy in Patients with Stroke-in-Evolution.
abstract: BACKGROUND
  The feasibility and efficacy of intracranial stenting were evaluated for patients with a stroke-in-evolution after the time window for thrombolysis.
  
  
  METHODS
  Patients with symptomatic intracranial steno-occlusive disease with progressive or fluctuating symptoms were treated using intracranial stenting after the time window for hyperacute thrombolysis.
  
  
  RESULTS
  Within the study period, we identified 10 patients (7 men, 62.5 ± 11.3 years old) who were eligible for inclusion. The median onset-to-arrival time was 5.8 hours (range: .6-144 hours), and the median onset-to-procedure time was 33 hours (range: 8-346 hours). Only 1 patient previously received intravenous thrombolysis using alteplase. The symptomatic occlusive artery was the right middle cerebral artery, left middle cerebral artery, and basilar artery in 3, 1, and 6 patients, respectively. The median initial National Institutes of Health Stroke Scale (NIHSS) score was 4 (range: 0-6), and the median NIHSS score measured immediately before the procedure was 8 (range: 4-26). All but 1 patient underwent successful angioplasty and stenting using a Wingspan stent. Reocclusion of the stented artery occurred in 1 patient, and his neurological status deteriorated to coma. A favorable outcome (modified Rankin Scale ≤2) at 3 months was noted in 7 patients (70%).
  
  
  CONCLUSIONS
  Intracranial stenting could be considered an alternative strategy for treating patients with medically intractable stroke-in-evolution.
authors.affiliation: Department of Neurology, College of Medicine, Korea University Guro Hospital, Korea University, Seoul, Republic of Korea.
authors.forename: Woo-Keun
authors.initials: WK
authors.lastname: Seo
authors.affiliation: Department of Neurology, College of Medicine, Korea University Guro Hospital, Korea University, Seoul, Republic of Korea.
authors.forename: Kyungmi
authors.initials: K
authors.lastname: Oh
authors.affiliation: Department of Radiology, College of Medicine, Korea University Guro Hospital, Korea University, Seoul, Republic of Korea. Electronic address: ssickh@korea.ac.kr.
authors.forename: Sang-Il
authors.initials: SI
authors.lastname: Suh
authors.affiliation: Department of Radiology, College of Medicine, Korea University Guro Hospital, Korea University, Seoul, Republic of Korea.
authors.forename: Hae Young
authors.initials: HY
authors.lastname: Seol
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000295:instrumentation*; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation; D038524:Diffusion Magnetic Resonance Imaging; D004185:Disability Evaluation; D018450:Disease Progression; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012042:Registries; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome; D014654:Vascular Patency; D014715:Vertebrobasilar Insufficiency / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*
keywords: Brain infarct; neurological deterioration; outcome; stents