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Title: Solving the Issue of Restenosis After Stenting of Intracranial Stenoses: Experience with Two Thin-Strut Drug-Eluting Stents (DES)—Taxus Element™ and Resolute Integrity™

PurposeThin-strut, flexible DES are suitable for intracranial stenting and may improve long-term vessel patency. The purpose of this study was to report our experience with two new-generation DES for the treatment of intracranial atherosclerotic disease.Patients and MethodsWe retrospectively reviewed all patients treated with Taxus Element™ or Resolute Integrity™ stent for an intracranial atherosclerotic stenosis between March 2011 and August 2013. Technical success was defined as the ability to deploy the device at the desired location and reduce the degree of stenosis below 50 %. All procedure-related strokes were recorded. Control angiography was scheduled after 6 weeks, 3, 6, and 12 months and yearly thereafter. A luminal narrowing ≥50 % was regarded as a restenosis. Stroke recurrence in the territory of the treated artery was reported.ResultsIn the defined period we treated 101 patients harboring 117 intracranial stenoses. The procedure was successful in 100 (85.5 %) lesions. Procedure-related strokes occurred in 10 (9.9 %) patients with a permanent morbidity in 3 (3.0 %). Follow-up angiography was available for 83 of 100 (83.0 %) successfully treated lesions with an average of 355 days (IQR 153–482 days). Three (3.6 %) asymptomatic restenoses were detected. All occurred after treatment with Resolute Integrity™, none after Taxus Element™ (p = 0.059). New strokes in the territory of the treated arterymore » were encountered in 2 (2.6 %) occasions.ConclusionThin-strut DES improve long-term patency and reduce the risk of subsequent stroke. Differences between devices may exist. Feasibility is comparable to bare-metal balloon-mounted stents and procedure-related strokes occurred within the expected range.« less
Authors:
;  [1] ;  [2] ;  [3] ; ;  [4] ;  [1]
  1. Klinikum Stuttgart, Klinik für Diagnostische und Interventionelle Neuroradiologie (Germany)
  2. Universitätsklinikum Knappschaftskrankenhaus Bochum GmbH, Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie und Nuklearmedizin (Germany)
  3. Klinikverbund Südwest, Klinikum Sindelfingen, Klinik für Neurologie (Germany)
  4. Klinikum Stuttgart, Klinik für Neurologie (Germany)
Publication Date:
OSTI Identifier:
22469953
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 38; Journal Issue: 3; Conference: CIRSE 2015: Cardiovascular and Interventional Radiological Society of Europe congress, Lisbon (Portugal), 26-30 Sep 2015; Other Information: Copyright (c) 2015 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ARTERIES; BIOMEDICAL RADIOGRAPHY; COMPARATIVE EVALUATIONS; DISEASE INCIDENCE; EQUIPMENT; HEALTH HAZARDS; PATIENTS; PHENOBARBITAL; REVIEWS