Stent-assisted Intracranial Recanalization for Acute Stroke: Early Results

Abstract

Stent-assisted recanalization for acute stroke resulting from intracranial thrombotic occlusion is associated with a high recanalization rate and low intracranial hemorrhage rate. These initial results suggest that stenting may be an option for recalcitrant cerebral arterial occlusions.

Intracranial Stent Placement for Recanalization of Acute Cerebrovascular Occlusion in 32 Patients

“…[2][3][4][5] Several authors have reported that intracranial stents could be used for AIS management with high recanalization and low complication rates. [6][7][8][9][10] Levy et al 7 reported 19 cases of intracranial stent placement for recanalizing vessels that were resistant to standard thrombolytic techniques, demonstrating a 79% recanalization rate of TIMI/TICI 2 or 3 with balloonmounted stents. One year later, Levy et al 8 also reported 18 cases of self-expandable stents for recanalization of acute cerebrovascular occlusion, demonstrating a 79% recanalization rate of TIMI/TICI 2 or 3 with Neuroform 3 and Wingspan stents (Boston Scientific/Target).…”

“…[3][4][5][6][7][8][9][10]15 We assume that the high rate of dissection might be caused by relatively old age, vessel tortuosity, the previously existing vascular stenosis, and the emergent procedures with narrow time windows. In addition, all dissections were related to manipulation of balloonmounted stents, not to self-expandable stents.…”

“…7,8,10 Brekenfeld et al 9 reported a 0% rate of ICH. However, except for our 1 case of iatrogenic tear of an M1 with a wire, we do not believe that there was a definite cause in our IAT, including timing of IAT, doses of thrombolytic agents, intra-arterial injection methods of thrombolytic agents, and techniques of mechanical thrombolysis by using a wire and balloons.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12] Among them, stents have been reported as an option for improvement of the recanalization rate and have shown excellent results with an acceptably low complication rate. [6][7][8][9][10][11][12] The authors have also used intracranial stents in failed cases of IAT with pharmacologic and mechanical methods since 2004. We also experienced good results in terms of recanalization.…”

Endovascular management of acute ischemic stroke

“…The largest and most current study retrospectively analyzed 19 patients with acute stroke who underwent intracranial stent placement after failure of pharmacological and/or mechanical thrombolysis. 19 All patients had an NIHSS score > 16 with 8 occlusions in the ICA terminus, 7 in the MCA, and 4 in the basilar artery. The overall recanalization rate was 79% with only 1 asymptomatic ICH.…”