Role of balloon-expandable stents in intracranial atherosclerotic disease in a series of 182 patients

Abstract

Background and purpose: To demonstrate the safety and efficacy of balloon-expandable intracranial stents in patients with intracranial atherosclerotic lesions (>70% stenosis) who were symptomatic despite being on optimum medical therapy.

Methods: Between April 2004 and May 2012, 182 patients underwent intracranial stenting in our institution. All patients had symptoms despite being on optimum medical therapy. Clinical follow-up was done at 1, 3, 6, and 12 months. Angiographic follow-up was done at 1 year in 121 patients.

Results: Technical success was achieved in 97.44% of the cases. The incidence of all strokes at 1 month after procedure was 11 (5.64%), of which 2 (1.02%) were major, both related to stent thrombosis not responding to tirofiban, and 9 (4.61%) were minor. Periprocedural minor stroke was seen in 9 patients. There were 2 deaths in our study (mortality=1.09%).

Conclusions: Treatment of intracranial atherosclerotic disease with balloon-expandable intracranial stents is a safe and effective method with acceptable adverse events, especially in patients who failed medical therapy and were symptomatic despite being on optimum medical therapy.

Keywords: intracranial stenosis; stenting; stroke.