Endovascular treatment of symptomatic intracranial atheromatous stenosis: A single center study of 21 consecutive cases

Summary Objectives This retrospective single-center study evaluated the technical success as well as the periprocedural and long-term complications of angioplasty with stenting of symptomatic intracranial atheromatous stenosis. Patients and methods From January 2005 to December 2010, 21 patients wer...

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Bibliographic Details
Published in:Journal of neuroradiology 2012-12, Vol.39 (5), p.332-341
Main Authors: Chavent, A, Kazemi, A, Voguet, C, Osseby, G.-V, Palova, E, Ricolfi, F
Format: Article
Language:English
Subjects:
Adult
Age
Aged
Aged, 80 and over
Angioplasty
Angioplasty - methods
Cardiovascular system
Constriction, Pathologic - diagnostic imaging
Constriction, Pathologic - surgery
Female
Humans
Implants
Intracranial Arterial Diseases - diagnostic imaging
Intracranial Arterial Diseases - surgery
Intracranial stenosis
Ischemia
Male
Middle Aged
Neuroimaging
Plaque, Atherosclerotic - diagnostic imaging
Plaque, Atherosclerotic - surgery
Radiography
Radiology
Retrospective Studies
Stenosis
Stent
Stroke
Transient ischemic attack
Treatment Outcome
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Summary:Summary Objectives This retrospective single-center study evaluated the technical success as well as the periprocedural and long-term complications of angioplasty with stenting of symptomatic intracranial atheromatous stenosis. Patients and methods From January 2005 to December 2010, 21 patients were treated by angioplasty with stent implantation for symptomatic atheromatous intracranial stenosis greater or equal to 50% at least 7 days after a stroke. Results The median population age was 65 years (range: 41–88 years), and 76% (16/21) of the candidates had a history of transient ischemic attack (TIA) or stroke before the event qualifying them for an endovascular procedure. In addition, 86% (18/21) were taking antithrombotic medication at the time of the qualifying event. Technical success was obtained in all cases. The periprocedural stroke or death rate was 9.5% (2/21), and there was no other stroke or death after 30 days during the mean follow-up of 1.4 years. Conclusion Endovascular treatment of symptomatic intracranial atherothrombotic stenosis can lead to severe complications, particularly during the periprocedural period, but it also represents the only alternative treatment for patients who fail with medical therapy. Future studies need to focus on improvement of periprocedural complications. Essentially, this should include more rigorous selection of candidates as well as a better understanding of the pathophysiological mechanism(s) of the ischemic phenomenon related to stenosis.
ISSN:0150-9861
DOI:10.1016/j.neurad.2012.02.003