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Safety, feasibility, and short-term follow-up of drug-eluting stent placement in the intracranial and extracranial circulation Gupta R; Al-Ali F; Thomas AJ; Horowitz MB; Barrow T; Vora NA; Uchino K; Hammer MD; Wechsler LR; Jovin TGStroke 2006[Oct]; 37 (10): 2562-6BACKGROUND AND PURPOSE: The use of bare metal stents to treat symptomatic intracranial stenosis may be associated with significant restenosis rates. The advent of drug-eluting stents (DESs) in the coronary circulation has resulted in a reduction of restenosis rates. We report our technical success rate and short-term restenosis rates after stenting with DESs in the intracranial and extracranial circulation. METHODS: This study was a retrospective review of the period between April 1, 2004, and April 15, 2006, of 59 patients with 62 symptomatic intracranial or extracranial atherosclerotic lesions at 2 medical centers (University of Pittsburgh and Borgess Medical Center). RESULTS: The mean age of our cohort was 61+/-12 years. The location of the 62 lesions was as follows: extracranial vertebral artery 31 (50%), intracranial vertebral artery or basilar artery 18 (29%), extracranial internal carotid artery (ICA) near the petrous bone 5 (8%), and intracranial ICA 8 (13%). There were 2 (3%) periprocedural complications: 1 non-flow-limiting dissection and 1 disabling stroke. Fifty vessels were available for follow-up angiography or computed tomography angiography at a median time of 4.0+/-2 months. A total of 2 of 36 extracranial stents (7%) and 1 of 26 intracranial stents (5%) were found to have restenosis > or = 50% at follow-up. CONCLUSIONS: This report demonstrates that DES delivery in the intracranial and extracranial circulation is technically feasible. A small percentage of patients developed short-term in-stent restenosis. Longer-term follow-up is required in the setting of a prospective study to determine the late restenosis rates for DESs in comparison with bare metal stents.|*Carotid Artery, External[MESH]|*Carotid Artery, Internal[MESH]|Anticoagulants/therapeutic use[MESH]|Aortic Dissection/etiology[MESH]|Calcinosis/therapy[MESH]|Carotid Stenosis/prevention & control/*therapy[MESH]|Catheterization[MESH]|Cohort Studies[MESH]|Drug Evaluation[MESH]|Drug Implants[MESH]|Feasibility Studies[MESH]|Female[MESH]|Follow-Up Studies[MESH]|Humans[MESH]|Ischemic Attack, Transient/drug therapy/prevention & control/therapy[MESH]|Male[MESH]|Middle Aged[MESH]|Organ Specificity[MESH]|Paclitaxel/administration & dosage/adverse effects/*therapeutic use[MESH]|Recurrence[MESH]|Retrospective Studies[MESH]|Sirolimus/administration & dosage/adverse effects/*therapeutic use[MESH]|Stents/adverse effects/*statistics & numerical data[MESH]|Stroke/etiology[MESH]|Vertebrobasilar Insufficiency/prevention & control/*therapy[MESH] |
