Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Urgent Recanalization with Stenting for Severe Intracranial Atherosclerosis after Transient Ischemic Attack or Minor Stroke

  • Park, Tae-Sik (Department of Neurosurgery, Wallace Memorial Baptist Hospital) ;
  • Choi, Beom-Jin (Department of Neurosurgery, Pohang Stroke and Spinal Hospital) ;
  • Lee, Tae-Hong (Department of Diagnostic Radiology, Pusan National University Hospital) ;
  • Song, Joon-Suk (Department of Neurosurgery, Wallace Memorial Baptist Hospital) ;
  • Lee, Dong-Youl (Department of Neurosurgery, Wallace Memorial Baptist Hospital) ;
  • Sung, Sang-Min (Department of Neurology, Pusan National University Hospital)
  • Received : 2011.05.11
  • Accepted : 2011.10.17
  • Published : 2011.10.28
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Abstract

Objective : Stenting of symptomatic intracranial stenosis has recently become an alternative treatment modality. However, urgent intracranial stenting in patients with intracranial stenosis following a transient ischemic attack (TIA) or minor stroke is open to dispute. We sought to assess the feasibility, safety, and effectiveness of urgent intracranial stenting for severe stenosis (>70%) in TIA or minor stroke patients. Methods : Between June 2009 and October 2010, stent-assisted angioplasty by using a balloon-expandable coronary stent for intracranial severe stenosis (>70%) was performed in 7 patients after TIA and 5 patients after minor stroke (14 stenotic lesions). Technical success rates, complications, angiographic findings, and clinical outcomes were retrospectively analyzed. Results : Stenting was successful in all 12 patients. The mean time from symptom onset to stenting was 2.1 days (1-8 days). Post-procedural angiography showed restoration to a normal luminal diameter in all patients. In-stent thrombosis occurred in one patient (n=1, 8.3%), and was lysed with abciximab. No device-related complications, such as perforations or dissections at the target arteries or intracranial hemorrhaging, occurred in any patient. The mortality rate was 0%. No patient had an ischemic event over the mean follow-up period of 12.5 months (range, 7-21 months), and follow-up angiography (n=7) revealed no significant in-stent restenosis (>50%). Conclusion : Urgent recanalization with stenting is feasible, safe, and effective in patients with TIA or acute minor stroke with intracranial stenosis of ${\geq}$ 70%.

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References

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