Long-Term Outcome of Enterprise Stenting for Symptomatic ICAS in a High-Volume Stroke Center

Cui, Ruixia; Yan, Long; Kang, Kaijiang; Yang, Ming; Yu, Ying; Mo, Dapeng; Gao, Feng; Wang, Yongjun; Lou, Xin; Miao, Zhongrong; Ma, Ning

doi:10.3389/fneur.2021.672662

Cited by 11 publications

(5 citation statements)

References 29 publications

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“…This requires not only strict adherence to relevant indications and selection of experienced operators, but also use of good flexible stents to reduce complications. Compared with the Wingspan stent, the Enterprise stent has better flexibility and smaller radial force, which is beneficial to reducing perioperative complications [ 26 ]. The Enterprise stent is of closed-cell design, easier to operate, and easily delivered through microcatheters.…”

Section: Discussionmentioning

confidence: 99%

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Safety and efficacy of enterprise stenting for symptomatic atherosclerotic severe posterior circulation stenosis

Zhou,

Li,

Zhu

et al. 2023

Eur J Med Res

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Purpose To investigate the safety and efficacy of Enterprise stent angioplasty and risk factors for the prognoses in treating symptomatic severe posterior circulation atherosclerotic stenosis (SSPCAS). Materials and methods Patients with SSPCAS who were treated with the Enterprise stent angioplasty were retrospectively enrolled. The clinical data, peri-procedural complications, postoperative residual stenosis, in-stent restenosis and recurrent stroke at follow-up were analyzed. Results 262 patients with 275 stenotic lesions treated with the Enterprise stent angioplasty were enrolled. The stenosis degree was reduced from 86.3 ± 6.2% before to 19.3 ± 5.4% after stenting. Complications occurred in 14 (5.3%) patients. Clinical follow-up was performed in 245 (93.51%) patients for 16.5 ± 7.3 months. During 1 year follow-up, 7 patients (2.9%) had recurrent symptoms, including 4 patients with stenting in the intracranial vertebral artery and 3 in the basilar artery. Imaging follow-up was conducted in 223 (85.11%) patients. In-stent restenosis was present in 35 patients (15.7%), with the restenosis rate of 26.4% (n = 23) in the intracranial vertebral artery, which was significantly (P < 0.001) greater than in the basilar artery (8.8%). Six patients (17.1%) with in-stent restenosis were symptomatic. The stenotic length was the only significant (P = 0.026 and 0.024, respectively) independent risk factor for 1 year stroke or death events and in-stent restenosis. Conclusion The Enterprise stent can be safely and efficaciously applied in the treatment of symptomatic severe posterior circulation atherosclerotic stenosis, with a relatively low rate of in-stent restenosis and recurrent stroke within 1 year. The stenotic length was the only significant independent risk factor for 1 year stroke or death events and in-stent restenosis.

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Section: Discussionmentioning

confidence: 99%

“…They can be retrieved when the release rate is less than 70%, which makes the release more accurate. In addition, a softer flexible delivery microcatheter can be used to deliver the Enterprise stent through tortuous vessels to smaller terminal vessels [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of enterprise stenting for symptomatic atherosclerotic severe posterior circulation stenosis

Zhou,

Li,

Zhu

et al. 2023

Eur J Med Res

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“…The patients in this study all had a history of stroke, including male proportion, patient age, hypertension, diabetes, hyperlipidemia, IS events to endovascular treatment time. However, one study showed that 14.4% of patients still had ingratiatory restenosis (stenosis of more than 70%) within 1 year ( 29 ). In addition, a previous study showed that the average follow-up rate of ICAS after Enterprise stent treatment was 24.7% (stenosis exceeded 50%), which was higher than the restenosis rate (6.9%) (Stenosis more than 50%) at 6 months follow-up in this study ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

A retrospective study of individualized endovascular treatment for symptomatic intracranial atherosclerotic stenosis in patients with ischemic stroke/transient ischemic attack

Mao

Liu

et al. 2022

Front. Neurol.

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BackgroundEndovascular treatment (EVT) is one of the effective treatment procedure for the symptomatic intracranial atherosclerotic stenosis (sICAS).Aim and methodsWe evaluated the efficacy and safety of individualized endovascular treatment for sICAS patients. Clinical and imaging follow-ups were carried out to collect the data of 29 sICAS patients after 6 months of individualized endovascular treatment. Different treatment strategies are selected based on arterial access and lesion morphology of patients. If standard surgical path, narrow artery straight, stenosis length ≤10 mm, then the appropriate specifications of balloon-mounted stent (BMS) treatment. the surgical path is tortuous, the narrow artery is curved, the angle is apparent, the diameter of the near and far ends is significantly different, or the length of the stenosis is >10 mm, self-expanding stent (SES) with appropriate specifications is selected for treatment. If the narrowed artery is hyper flexed and the surgeon deems stenting inappropriate, balloon dilation angioplasty (BDA) treatment is chosen.Results and conclusion31 lesions of 29 sICAS patients received endovascular treatment. The median age was 61 years (IQR 54–69 years). The median preoperative stenosis was 90% (IQR 80–95%), and the mean stenosis length was (8.10 ± 3.27) mm. The most commonly used surgical procedure was Balloon-Mounted Stent (BMS) in 19 cases (65.52%), Self-expanding Stent (SES) in seven cases (24.14%), Balloon Dilation Angioplasty (BDA) in three cases (10.34%). (11.86 + 1.46 mm) was greater than that in the BMS group (6.14 + 1.59 mm) (P < 0.001). The median stenosis was 90% (IQR 80–92.5%) in the BMS group, lower than 99% (IQR 95–100%) in the SES group (P < 0.001). The median post-operative residual stenosis was 20% (IQR 15–25%), significantly improved compared with preoperative (P < 0.001). The success rate of the surgical technique was 93.10% (27/29). One patient (3.45%) had IS recurrence within 48 h after surgery, and the restenosis rate within 6 months after surgery was 6.90% (2/29). No patient died or had recurrent IS. Our data demonstrated that individualized endovascular treatment method could be potentially significant and safe for sICAS patients. This study will provide an important reference for the endovascular treatment of sICAD.

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“…Although self-expanding stents, such as the Wingspan® stent system (Stryker), have been discredited by SAMMPRIS and VISSIT, careful patient selection and a focus on findings from medical centers with extensive experience in endovascular treatment have revealed much better results in ICAS treatment than VISSIT/SAMMPRIS [ 127 , 128 , 129 ]. Two large randomized multicenter studies are currently underway and aim to address the safety and effectiveness of self-expanding stent PTA in ICAS treatment.…”

Section: Discussionmentioning

confidence: 99%

Drug-coated Balloons in the Neurovascular Setting: A Comprehensive, Systematic Review of Current Use and Indications

Gottberg¹,

Cimpoca²,

Wendl³

et al. 2022

Rev. Cardiovasc. Med.

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Background: Drug-coated balloons (DCB) are an established tool in the prevention and treatment of coronary and peripheral artery restenosis. The underlying effects of restenosis resemble those in the neurovascular field, yet data on the use of DCB in cervical and intracranial arteries is rare. Methods: Medline, and international and major national guidelines and recommendations were systematically searched for data addressing the use of DCB in the neurovascular setting. Results: Of the 1448 relevant records found in Medline, 166 publications were considered for this review. Conclusions: Data on the use of DCB in the neurovascular setting show a possible benefit over preceding alternatives, such as self-expanding stents, and balloon-mounted or drug-eluting stents. Nonetheless, the role of DCB remains under-researched, and publications remain lacking.

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Long-Term Outcome of Enterprise Stenting for Symptomatic ICAS in a High-Volume Stroke Center

Cited by 11 publications

References 29 publications

Safety and efficacy of enterprise stenting for symptomatic atherosclerotic severe posterior circulation stenosis

Safety and efficacy of enterprise stenting for symptomatic atherosclerotic severe posterior circulation stenosis

A retrospective study of individualized endovascular treatment for symptomatic intracranial atherosclerotic stenosis in patients with ischemic stroke/transient ischemic attack

Drug-coated Balloons in the Neurovascular Setting: A Comprehensive, Systematic Review of Current Use and Indications

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