PurposeProcedural safety and high rates of in-stent recurrent stenotic lesions (ISR) remain a concern in the endovascular treatment of intracranial atherosclerotic disease (ICAD). In the present study technical feasibility, safety and efficacy of the paclitaxel eluting balloon-expandable coronary stent Coroflex® Please was assessed in the treatment of ICAD.MethodsA total of 95 patients (79 male; median age 68 years) with 106 intracranial atherosclerotic stenotic lesions underwent endovascular treatment using Coroflex® Please stents (B. Braun, Melsungen, Germany). Location and degree of target stenoses before and after treatment and at follow-up and adverse clinical sequelae of treatment were registered. Post-procedural medication included 100 mg acetylsalicylic acid (ASA) and 75 mg clopidogrel for 1 year. Angiographic follow-up was scheduled for 6, 12, 26 and 52 weeks after the treatment.ResultsThe lesion locations were as follows: internal carotid artery (ICA) petrous (n = 44, 42%), ICA cavernous (n = 43, 41%), ICA paraclinoid (n = 4, 4%), intradural vertebral artery (VA; n = 11, 10%) and basilar artery (BA; n = 4, 4%). Of the lesions seven could not be treated due to difficult anatomy and stent stiffness (7% technical failure rate). The combined post-interventional neurological morbidity and mortality rate, including stroke, intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH) and carotid cavernous fistula (CCF) was n = 4 (3.7%) within and n = 1 (0.9%) at and beyond 30 days, respectively. Angiographic and clinical follow-up examinations were carried out for 78 (78%) of the lesions (mean 16.1 months, maximum 48 months). Asymptomatic recurrent stenosis was seen in 3 out of 78 (3.8%) lesions and there was 1 case of late stent thrombosis (0.9%).ConclusionsTreatment of ICAD using drug-eluting coronary stents is safe and effective but technical failure due to stent stiffness remains a problem. Application of the more flexible, newest generation thin-strut stents, however, shows promising results.

Zusammenfassung Der menschliche Frontallappen unterscheidet sich wesentlich von dem anderer h?herer S?ugetiere. Mit einem Gr??enanteil von gut einem Drittel der gesamten kortikalen Oberfl?che ist der phylogenetisch j?ngste Kortexabschnitt beim Menschen weitaus gr??er als bei anderen h?heren Primaten. Dementsprechend herausgehoben ist sein Status in der Evolution 18. Lesen Sie aus neuropsychologischer Sicht welche Funktionen das menschliche Frontalhirn ?bernimmt und welche Symptome bei frontaler Sch?digung auftreten. Au?erdem beschreibt der Artikel kurz die aktuellen Testverfahren und unterzieht diese einer kritischen Bewertung ? inwieweit diese dem Anspruch, ?frontale? Leistungen zu messen, gerecht werden.