Abstract WP145: Medtronic Driver® Balloon-mounted Coronary Stent System In Endovascular Neurointervention: Off-label Clinical Experience At A Tertiary Referral Medical Center
Background: Balloon-mounted coronary stents have been employed in the endovascular management of ischemic cerebrovascular disease, where rapid and precise stenting with angioplasty may be performed in a patient with minimal or no sedation. The Medtronic Driver® balloon-mounted stent is known to have excellent trackability and deliverability, making it a viable tool in the armamentarium of the neurointerventional surgeon.
Methods: Retrospective review of 46 patients who underwent endovascular revascularization utilizing Medtronic Driver® stent from 2003-2011. Characteristics analyzed were patient demographics, lesion location, etiology of vascular lesion, degree of stenosis, extent of revascularization, short-term complications, and clinical outcome.
Results: Out of 46 patients with 51 Driver® stents studied, 21 were female and age of patients ranged from 37 to 91 years. The treatment data comprised of 22 internal carotid artery stents (19 patients) 1 common carotid artery stent, 25 vertebal artery stents (20 patients), and 3 basilar artery stents. 18 out of 51 stents were intracranial, including 7 ICA, 3 basilar and 8 vertebral artery. Extracranial stents comprised of 1 CCA, 15 ICA and 17 vertebral artery stents. Etiology of lesion included 41 stroke or TIA with symptomatic stenosis, 1 instent restenosis, and 4 dissections. Angiographically 5 patients had occluded vessels, 5 had <70% stenosis and 36 patients had 70-99% stenosis. The Driver® stent dimensions ranged from 3 mm x 9 mm to 4mm x 24 mm. Driver® stent placement failed in 2 cases and 4 patients developed instent-restenosis; two were stent occlusions in the same patient. Multiple Driver stents were used in 5 patients. 3 patients had symptomatic post-stenting hemorrhagic conversion and
4 deaths from non-procedure medical complications.
Conclusion: This study presents the largest single institution review of the Medtronic Driver® balloon- mounted coronary stent for use in neurointervention. The authors have demonstrated technical feasibility of the stent system and satisfactory revascularization in a variety of clinical indications.This device allows quick revascularization by performing stent-angioplasty together, and providing access for distal clot removal.
- © 2012 by American Heart Association, Inc.