RT Journal Article
SR Electronic
T1 Stenting with Acclino (flex) for symptomatic intracranial stenosis as secondary stroke prevention
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 1127
OP 1131
DO 10.1136/neurintsurg-2019-015744
VO 12
IS 11
A1 Meyer, Lukas
A1 Leischner, Hannes
A1 Thomalla, Goetz
A1 Krause, Lars Udo
A1 Lowens, Stephan
A1 Rothaupt, Jan
A1 Hanning, Uta
A1 Buhk, Jan Hendrik
A1 Fiehler, Jens
A1 Chapot, René
A1 Stracke, Christian Paul
A1 Bester, Maxim
YR 2020
UL http://jnis.bmj.com/content/12/11/1127.abstract
AB Background and purpose Stroke recurrence is high in patients with symptomatic intracranial stenosis despite best medical treatment. Based on evidence from past studies using previous stent generations, elective intracranial stenting (eICS) is considered in a minority of patients. This study aims to report on experience performing eICS with a novel device combination.Methods We retrospectively reviewed data from three high volume stroke centers and analyzed patients that were treated with eICS for symptomatic intracranial stenosis using the Acclino (flex) stent and the NeuroSpeed balloon catheter (Acandis GmbH, Pforzheim, Germany). Study endpoints were periprocedural rates of stroke regardless of territory or death at discharge and at the time of follow-up after eICS. Safety evaluation included asymptomatic and symptomatic intracranial hemorrhage, serious adverse events related to the intervention, and evaluation of stent patency at the time of follow-up.Results The median age of patients that met the inclusion criteria (n=76) was 69 years. Target vessels were located in the anterior circulation in 55.3% (42/76) of patients. The periprocedural stroke rate was 6.5% (fatal stroke 2.6%; non-fatal stroke 3.9%) at discharge after eICS. Asymptomatic intracranial hemorrhage was observed in 5.2% (4/76) of patients. Follow-up DSA revealed in-stent restenosis of 25% (15/60), and percutaneous transluminal angioplasty was performed again in 11.6% (7/60) of patients.Conclusion Stenting for symptomatic intracranial stenosis with the Acclino (flex)/NeuroSpeed balloon catheter seemed to be safe and reinforces eICS as an endovascular therapy option for secondary stroke prevention. Future studies are warranted to confirm these findings and investigate antithrombotic strategies and in-stent restenosis to minimize periprocedural complications and guarantee long term stent patency.