Intracranial angioplasty and stent implantation in atherosclerotic lesions

Česká verzia

Authors: F. Charvát ¹; J. Mašková ¹; J. Lacman ¹; V. Beneš ²
Authors place of work: Radiologické oddělení, ÚVN Praha ¹; Neurochirurgická klinika, 1. LF UK a VFN, Praha ²
Published in the journal: Cesk Slov Neurol N 2008; 71/104(2): 190-196
Category: Short Communication

Summary

Purpose:
Authors report periprocedural and short term results of intracranial stenoses treatment using angioplasty and stent implantation.

Methods:
In the period from 8/2002 to 4/2007 (56 months) altogether 53 patients were treated in our department. Group consists of 12 women and 41 men (mean age 63 years), 48 lesions were symptomatic, 5 were asymptomatic. 56 procedures were performed with 53 stents implantations. 46 stenoses (84 %, n = 55) were located in anterior circulation. 9 stenoses were in posterior circulation (16 %). All procedures were done from femoral approach. Patients were put on clopidogrel (Plavix, Sanofi Pharma, Bristol-Meyer) and acetylsalicylic acid (Anopyrin, Zentiva, CZ) 3 days before the procedure. Bolus of heparin (Heparin Natrium, Zentiva, CZ) was given in the beginning of procedure. Combination of Plavix and Anopyrin was used for 1 month after the procedure and Anopyrin long-life. Balloon – expandable stents were used in 41 lesions (77 %, n = 53), self-expandable stents were used in 12 lesions (23 %, n = 53).

Results:
Primary technical success was achieved in 48 patients (91 %, n = 53), secondary technical success rate was 96 %. There were 9 periprocedural complications (16 %, n = 56), two minor, without sequelae, seven major leading to change of treatment and prolonged hospital stay. One procedure related dead occurred.

Conclusion:
Angioplasty with stent implantation was indicated in symptomatic patients with stenosis greater than 50 %. Our periprocedure results show, that stent implantation is technically feasible in most cases. The periprocedure results and complications rate in our group are comparable with those of other published studies.

Key words:
stroke – cerebral arteries – stent – intracranial atherosclerosis

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