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Stroke. 2004
Published online before print April 22, 2004, doi: 10.1161/01.STR.0000128708.86762.d6
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Right arrow Angioplasty and Stenting

Submitted on December 27, 2003
Revised on January 22, 2004
Accepted on March 3, 2004

Stenting of Symptomatic Atherosclerotic Lesions in the Vertebral or Intracranial Arteries (SSYLVIA): Study Results

The SSYLVIA Study Investigators

From the SSYLVIA Study Investigators.

Background and Purpose--Stroke rates in patients with symptomatic intracranial stenosis may be as high as 10% to 24% per year on medical therapy. This multicenter, nonrandomized, prospective feasibility study evaluated the NEUROLINK System for treatment of vertebral or intracranial artery stenosis.

Methods--Patients were 18 to 80 years old with symptoms attributed to a single target lesion of >=50% stenosis. Patients received 5 neurological examinations before and in the year after the procedure, and another angiogram at 6 months.

Results--In 61 patients enrolled, 43 (70.5%) intracranial arteries (15 internal carotid, 5 middle cerebral, 1 posterior cerebral, 17 basilar, 5 vertebral) and 18 (29.5%) extracranial vertebral arteries (6 ostia, 12 proximal to the posterior inferior cerebellar artery [PICA]) were treated. In the first 30 days, 4 patients (6.6%) had strokes and no deaths occurred. Successful stent placement was achieved in 58/61 cases (95%). At 6 months, stenosis of >50% occurred in 12/37 (32.4%) intracranial arteries and 6/14 (42.9%) extracranial vertebrals, 4 in the vertebral ostia. Seven (39%) recurrent stenoses were symptomatic. Four of 55 patients (7.3%) had strokes later than 30 days, 1 of which was in the only patient not stented.

Conclusions--The NEUROLINK System is associated with a high rate of successful stent deployment. Strokes occurred in 6.6% of patients within 30 days and in 7.3% between 30 days and 1 year. Although restenoses occurred in 35% of patients, 61% were asymptomatic. Further trials involving the NEUROLINK System are warranted.
Key words: intracranial pressure • stenosis • stents • stroke




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 NEJMHome page
A. Riecker, U. Ernemann, and A. Kastrup
Cerebellar Hemorrhage after Angioplasty
N. Engl. J. Med., February 10, 2005; 352(6): 633 - 634.
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 StrokeHome page
D. Pelz, T. Andersson, P. Lylyk, M. Negoro, and M. Soderman
Stroke Review: Advances in Interventional Neuroradiology 2004
Stroke, February 1, 2005; 36(2): 211 - 214.
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 StrokeHome page
R. A. Koenigsberg and N. Vakil
The Often-Neglected Vertebral Artery
Stroke, November 1, 2004; 35(11): 2433 - 2434.
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 JWatch NeurologyHome page
Stenting for Intracranial Stenosis: Risk Reduction Is a Moving Target
Journal Watch Neurology, July 9, 2004; 2004(709): 1 - 1.
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