Intracranial arterial stenting for symptomatic stenoses: a Latin American experience

Surg Neurol. 2007 Oct;68(4):378-86. doi: 10.1016/j.surneu.2006.11.062.

Abstract

Background: The proportionally higher incidence of intracranial atherosclerosis among Asian and black patients and a greater proclivity for intracranial artery stenosis in the Hispanic population merit drawing attention to a Latin American experience with intracranial arterial stenting.

Methods: This is a retrospective analysis of an observational study of 33 intracranial lesions (each >50% stenosis) in 32 patients treated by intracranial angioplasty in 6 Latin American centers over a 3-year period. The investigation used a unique device, a balloon-expandable stent (Lekton Motion stent system, now Pharos, Biotronik, AG, Bülach, Switzerland).

Results: The treated patients ranged in age from 30 to 81 years (mean, 59.3 years; SD, 12 years), including 24 male and 8 female patients (sex ratio, 4:1). Two were Asians, 4 were blacks, and the rest were white Hispanic. Our mean follow-up is of 10.2 months (SD, 7.84 months), with a mortality rate of 9.4% (3/32), a nonfatal complication rate of 6.2%, and a stroke rate (rate of recurrence) of 0%. The mean pretreatment stenosis of 68.75% (SD, 14%) was reduced to a residual of 5.16% (SD, 16%) (P = .000; 95% confidence interval, 56.8%-70.3%). A control angiogram was performed in 82% of patients, and in that case, the restenosis 50% or greater was of 8.7% during the follow-up period.

Conclusion: The treatment of intracranial stenosis with the Lekton Motion stent (Pharos) is feasible with a high technical success rate. Restenosis as well as the rate of new neurologic events during follow-up suggests some efficacy of stroke prevention by using the latest-generation, highly trackable, balloon-expandable stents.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angioplasty
  • Anticoagulants / therapeutic use
  • Atherosclerosis / complications
  • Cerebral Angiography
  • Cerebral Arterial Diseases / etiology
  • Cerebral Arterial Diseases / mortality
  • Cerebral Arterial Diseases / surgery*
  • Constriction, Pathologic
  • Endpoint Determination
  • Female
  • Follow-Up Studies
  • Humans
  • Latin America
  • Male
  • Middle Aged
  • Neurosurgical Procedures
  • Postoperative Complications / epidemiology
  • Postoperative Complications / therapy
  • Preoperative Care
  • Recurrence
  • Retrospective Studies
  • Stents*

Substances

  • Anticoagulants