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AJNR - American Journal of Neuroradiology

Published ahead of print on September 3, 2008
doi: 10.3174/ajnr.A1221

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American Journal of Neuroradiology 29:1956-1958, November-December 2008
© 2008 American Society of Neuroradiology

Case Report
INTERVENTIONAL

Navigability Trumps All: Stenting of Acute Middle Cerebral Artery Occlusions with a New Self-Expandable Stent

P.T.L. Chiam^a,c, R.M. Samuelson^a,c, J. Mocco^a,c, R.A. Hanel^d, A.H. Siddiqui^a,b,c, L.N. Hopkins^a,b,c and E.I. Levy^a,b,c

^a Department of Neurosurgery and Toshiba Stroke Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
^b Department of Radiology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
^c Department of Neurosurgery, Millard Fillmore Gates Hospital, Kaleida Health, Buffalo, NY
^d Department of Neurosurgery, Mayo Clinic, Jacksonville, Fla

Please address correspondence to Elad I. Levy, MD, Department of Neurosurgery and Toshiba Stroke Research Center, University at Buffalo, State University of New York, 3 Gates Circle, Buffalo, NY 14209; e-mail: elevy{at}buffns.com

SUMMARY: Acute stroke intervention is rapidly evolving. New technologies are improving device deliverability and rates of recanalization. We describe 2 cases of acute middle cerebral artery occlusions wherein Wingspan stents could not be delivered to the occlusive site because of excessive vascular tortuosity. Merci thrombectomy was also unsuccessful. Revascularization was only achieved with deployment of the highly navigable Enterprise stent, resulting in thrombolysis in myocardial infarction 2/3 flow. Thus, all devices should be considered in the armamentarium of stroke therapy.

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