ANGIOPLASTY AND STENTING FOR SYMPTOMATIC ATHEROSCLEROTIC INTACRANIAL STENOSIS: PROCEDURES AND OUTCOME IN 28 CONSECUTIVE PATIENTS WITH 33 INTRACRANIAL STENOSIS

Background/Objective Elective intracranial stenting with or without balloon angioplasty is an emerging innovative therapy for intracranial vessels stenosis. Few and heterogeneous data about safety and efficacy of this kind of procedure are available. No randomized controlled trial is available. The aim of this paper is to present the experience in stenting and angioplasty on a series of consecutive symptomatic patients with intracranial vessels stenosis. Patients and Methods In the Neuroradiology Department of IRCCS Policlinico Hospital of Milan, from January 2002 to July 2006 a series of 28 consecutive patients, undergone endovascular treatment for 33 symptomatic intracranial vessels stenosis, were evaluated. 22 patients (24 procedures), previously treated using ballon-mounted stent delivery systems for coronary use, were retrospectively reviewed. 7 patients, who were to be treated with self-expanding stent-systems (WingSpan), were prospectively enrolled from March 2006 to July 2006. For each patient we collected data about intra-procedural complications and short-term outcome. The technical success was defined as a residual stenosis of less than 50%. Results 14 internal carotid, 10 vertebral and 9 basilar were treated in 28 patients with recently symptomatic intracranial stenosis >/= 70% on angiography. A technical success was achieved in all cases. No intraprocedural complications were observed. Revascularization led to hemorrhagic complications in two patients. No vessel dissections or ruptures were observed. Three of 28 patients had new neurological symptoms within 24 hours (two transient ischemic attack and one non disabling stroke) and one patient developed a symptomatic basilar thrombosis at 10 days later successfully treated. Conclusions – Endovascular treatment can be performed with a high technical success rate. The procedures were performed with an acceptable complication rate according to literature.