Background and purpose 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 November 2011, stent-assisted angioplasty by using stent for intracranial severe stenosis (>70%) was performed in nine patients after TIA (12 stenotic lesions) and 19 patients after minor stroke (21 stenotic lesions). Technical success rates, complications, angiographic findings, and clinical outcomes were retrospectively analyzed.
Results Stenting was successful in all 28 patients. The mean time interval from stroke symptom onset to stenting was 4.2 days (1∼13 days). The mean pre-procedural stenosis was 83.3% (range 70%–95%), and the mean stenosis immediately after stent placement was 4.2%. In-stent thrombosis occurred in three lesions (n=3, 9.1%), and was lysed with abciximab. Procedure-related asymptomatic dissection occurred in one lesion (n=1, 3.0%), and was solved by implanting a second stent. No intracranial hemorrhage or vessel perforation occurred in any patient. During the mean follow-up period of 14.4 months (range, 2–31 months), one patient had a symptomatic in-stent restenosis (80%) after 6 months of stent placement.
Conclusion Urgent recanalization with stenting is feasible, safe, and effective in patients with TIA or acute minor stroke with intracranial stenosis of ≥70%.
Competing interests None.
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