Stent technology in ischemic stroke

Abstract

Atherosclerotic disease of the cerebral vasculature is a major cause of stroke worldwide. Atherosclerosis that is refractory to best medical management may require revascularization. In these instances, endovascular treatment provides a popular and safe alternative to open surgical techniques. The authors provide an overview of stent technology in the treatment of ischemic stroke, discussing the major studies evaluating stenting for extracranial carotid artery, vertebral artery, and intracranial atherosclerotic disease. The authors describe the commonly used stents with respect to their individual characteristics and technical limitations. Current and future developments in stent technology are also discussed, with areas for further innovation and clinical research.

Keywords: BMS = bare-metal stent; BVS = bioresorbable vascular scaffold; CAS = carotid artery stenting; CAVATAS = Carotid and Vertebral Artery Transluminal Angioplasty Study; CCA = common carotid artery; CE = Confirmité Européene; CEA = carotid endarterectomy; DEB = drug-eluting balloon; DES = drug-eluting stent; ISR = in-stent restenosis; PED = Pipeline Embolization Device; SAMMPRIS = Stenting and Aggressive Medical Therapy for Preventing Recurrent Stroke in Intracranial Stenosis; TZD = thiazolidinedione; VAS = vertebral artery stenosis; WASID = Warfarin–Aspirin Symptomatic Intracranial Disease; atherosclerotic disease; carotid endarterectomy; ischemic stroke; stent.