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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 26:2342-2348, October 2005
© 2005 American Society of Neuroradiology

INTERVENTIONAL

The Use of Balloon-Expandable Stents in the Management of Intracranial Arterial Diseases: A 5-Year Single-Center Experience

Iruena Moraes Kessler, Charbel Mounayer, Michel Piotin, Laurent Spelle, Jose Ricardo Vanzin and Jacques Moret

Department of Interventional Neuroradiology, Fondation Rothschild, Paris, France

Address correspondence to Jacques Moret, MD, Service de Neuroradiologie Interventionnelle, Hôpital de la Fondation Rothschild, 25–29 rue Manin, 75940 Paris Cedex 19, France

BACKGROUND AND PURPOSE: Although stent-assisted intracranial procedures are becoming a routine clinical practice, there have been relatively few large studies published in the literature regarding the application of the balloon-expandable stent technology in the treatment of intracranial arterial diseases. In this report, the authors reviewed their experience with 75 cases at a single center.

METHODS: From 1998 to 2003, 75 patients underwent percutaneous transluminal intracranial stent placement as a treatment for wide-necked intracranial aneurysms and atherosclerotic stenoses. The anatomy of the target lesions, technical details of the procedures, device functionality, procedure-related complications, and short-term outcomes were reviewed in a retrospective fashion.

RESULTS: The clinical indications included wide-necked intracranial aneurysms (59) and atherosclerotic stenoses (16). The stent was successfully deployed in 92% of the patients (69 of 75 cases). In the remaining 6 cases, the causes of failed stent deployment included arterial tortuosities (2), stent migration (2), fracture of the stent (1), and arterial perforation (1). The short-term outcome (mean follow-up, 7.5 months; range, 3–12 months) was evaluated by using the modified Rankin scale (MR spectroscopy 0–6). Fifty-three patients (70.6%) had excellent outcomes (MR spectroscopy 0–1), 12 (16%) had good outcomes (MR spectroscopy 2), and 5 (6.7%) had poor outcomes (MR spectroscopy 4–5). Five patients (6.7%) died.

CONCLUSION: The use of BES is associated with a high rate of hemorrhagic and ischemic complications, more specifically when used in the anterior circulation. Cases of large-necked aneurysms not treatable with balloon remodeling technique and atheromatous sclerosis could be eligible for this treatment.

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