J Korean Soc Radiol.  2011 Jul;65(1):53-59. 10.3348/jksr.2011.65.1.53.

Intracranial Stent Implantation for Drug Resistant Atherosclerotic Stenosis: Results of 52 Cases

• Kim KS
• Hwang DH
• Ko YH
• Kang IW
• Lee ES
• Han YM
• Kim IS
• Hur CW
• Min SJ

• KMID: 1443493
• DOI: http://doi.org/10.3348/jksr.2011.65.1.53

Abstract

PURPOSE
We evaluated the usefulness of intracranial stent implantation for treatment of drug resistant atherosclerotic stenoses.
MATERIALS AND METHODS
Between March 2004 and July 2007, we tried intracranial stent implantation in 49 patients with 52 lesions (anterior circulation 48 cases, posterior circulation 4 cases) who had an ischemic stroke with more than 50% of major cerebral artery stenosis. We classified the lesions by their location and morphology, analyzed the results in terms of the success rate, complication rate, and restenosis rate during the follow-up period.
RESULTS
Intracranial stent implantation was performed successfully in 43 cases (82.7%). In eight of the nine cases, the stent implantation failure was due to the tortuosity of the target vessel. There was no major periprocedural complication. One patient showed cerebellar infarction after the procedure. Mean residual stenoses decreased from 70.2% to 13.0%. Four cases (9.3%) demonstrated in-stent restenoses and more than 50% during the mean and 25.3/month after the follow-up period.
CONCLUSION
Success rate of intracranial stent implantation may improve on developing technique and more experience. Low rate of complication and restenosis suggest that we can consider intracranial stent implantation for treatment of drug resistant atherosclerotic stenoses.

MeSH Terms

Cerebral Arteries
Constriction, Pathologic
Follow-Up Studies
Glycosaminoglycans
Humans
Infarction
Intracranial Arteriosclerosis
Stents
Stroke
Glycosaminoglycans

Figure

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  Fig. 1 64 years old man who presented right side weakness and dysarthria. A, B. Angiography shows 66% stenosis (arrows) at M1 segment of left MCA. C, D. After inserted stent (arrows) above the lesion, angiography shows improved blood flow. E. Follow up after 38 months, MRA shows no significant abnormality. Note.-MCA = middle cerebral artery, MRA = magnetic resonance angiography

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  Fig. 2 55 years old woman who presented motor weakness and sensory change. A. Diffusion weighted and Perfusion MRI shows left frontal lobe infarct and decreased blood flow in the left ACA territory. B. Angiography shows long segmental severe (73%) stenosis (arrow) at supraclinoid portion of left ICA. C. After balloon angioplasty and stent (arrow) insertion, blood flow was improved. D. Follow up after 6 months, angiography shows restenosis (arrow) in stent. Note.-ACA = anterior cerebral artery, ICA = internal carotid artery

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