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Elective treatment of intracranial stenosis with the balloon-expandable Pharos Vitesse stent: 30-day stroke rate and complications
  1. Patrick von Schoenfeldt1,
  2. Anna Krützelmann2,
  3. Matthias Bußmeyer3,
  4. Anastasios Mpotsaris4,
  5. Michael Rosenkranz5,
  6. Jens Fiehler6,
  7. Werner Weber1,
  8. Jan-Hendrik Buhk6
  1. 1Department of Radiology and Neuroradiology, Klinikum Vest, Recklinghausen, Germany
  2. 2Department of Neurology, University Medical Center Hamburg Eppendorf (UKE), Hamburg, Germany
  3. 3Department of Neurology, Klinikum Vest, Recklinghausen, Germany
  4. 4Department of Radiology and Neuroradiology, University Cologne, Cologne, Germany
  5. 5Department of Neurology, Albertinen Krankenhaus, Hamburg, Germany
  6. 6Department of Neuroradiology, University Medical Center Hamburg Eppendorf (UKE), Hamburg, Germany
  1. Correspondence to Dr Jan-Hendrik Buhk, Department of Neuroradiology, University Medical Center Hamburg Eppendorf, Martinistr 52, Hamburg D-20246, Germany; jbuhk{at}uke.de

Abstract

Background and purpose Analysis of procedural results and 30-day outcome after intracranial angioplasty and stenting (ICAS) with the balloon-expandable Pharos Vitesse stent system in carefully selected high-risk patients in two high-volume neurovascular centers.

Materials and methods 92 patients scheduled for elective ICAS using Pharos Vitesse between August, 2008 and August, 2011 were included. All patients showed high-grade intracranial stenosis and recurrent ischemic events despite best medical treatment at that time. The stroke rates and complications were divided into procedural and 30-day short-term events.

Results Successful stent placement was achieved in all but one patient. Ischemic procedural complications occurred in three subjects. 30-Day complications and strokes were seen in four patients: two minor ischemic strokes, one fatal hemorrhage and one non-stroke-related death. Overall, strokes occurred in 6 out of 92 patients (6.5%, 95% CI 3.0% to 13.5%). The total stroke and death rate was 7.6% (95% CI 3.7% to 14.9%). No significant correlation with previously reported risk factors could be found, although a higher rate of ischemic strokes (four out of five) in the posterior circulation was recorded.

Conclusions In patients with intracranial stenosis who experience recurrent ischemic events despite best medical treatment, ICAS, using the balloon-expandable Pharos Vitesse stent, may still be considered as an individual treatment option in high-volume neurovascular centers.

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