on September 7, 2006
Published online before print September 7, 2006, doi: 10.1161/01.STR.0000242481.38262.7b
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Submitted on June 1, 2006
From the Department of Neurology (R.G., N.A.V., K.U., M.D.H., L.R.W., T.G.J.), University of Pittsburgh Medical Center, Pittsburgh, Pa; the Department of Neurology (R.G.), Michigan State University, East Lansing; Neurosurgery of Kalamazoo, LLC (F.A.-A., T.B.), Kalamazoo, Mich; and the Department of Neurosurgery (A.J.T., M.B.H., T.G.J.), University of Pittsburgh Medical Center, Pittsburgh, Pa. * To whom correspondence should be addressed. E-mail: jovintg{at}upmc.edu.
Background and Purpose--The use of bare metal stents to treat symptomatic intracranial stenosis may be associated with significant restenosis rates. The advent of drug-eluting stents (DESs) in the coronary circulation has resulted in a reduction of restenosis rates. We report our technical success rate and short-term restenosis rates after stenting with DESs in the intracranial and extracranial circulation. Methods--This study was a retrospective review of the period between April 1, 2004, and April 15, 2006, of 59 patients with 62 symptomatic intracranial or extracranial atherosclerotic lesions at 2 medical centers (University of Pittsburgh and Borgess Medical Center). Results--The mean age of our cohort was 61±12 years. The location of the 62 lesions was as follows: extracranial vertebral artery 31 (50%), intracranial vertebral artery or basilar artery 18 (29%), extracranial internal carotid artery (ICA) near the petrous bone 5 (8%), and intracranial ICA 8 (13%). There were 2 (3%) periprocedural complications: 1 non--flow-limiting dissection and 1 disabling stroke. Fifty vessels were available for follow-up angiography or computed tomography angiography at a median time of 4.0±2 months. A total of 2 of 36 extracranial stents (7%) and 1 of 26 intracranial stents (5%) were found to have restenosis Conclusions--This report demonstrates that DES delivery in the intracranial and extracranial circulation is technically feasible. A small percentage of patients developed short-term in-stent restenosis. Longer-term follow-up is required in the setting of a prospective study to determine the late restenosis rates for DESs in comparison with bare metal stents.
Revised on June 28, 2006
Accepted on July 12, 2006
Safety, Feasibility, and Short-Term Follow-Up of Drug-Eluting Stent Placement in the Intracranial and Extracranial Circulation
Rishi Gupta MD;
50% at follow-up.
Key words: angioplasty • intracranial stenosis • stenting • stents
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