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Stroke ; 37(10): 2562-6, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16960090

RESUMO

BACKGROUND 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.


Assuntos
Artéria Carótida Externa , Artéria Carótida Interna , Estenose das Carótidas/terapia , Paclitaxel/uso terapêutico , Sirolimo/uso terapêutico , Stents/estatística & dados numéricos , Insuficiência Vertebrobasilar/terapia , Dissecção Aórtica/etiologia , Anticoagulantes/uso terapêutico , Calcinose/terapia , Estenose das Carótidas/prevenção & controle , Cateterismo , Estudos de Coortes , Avaliação de Medicamentos , Implantes de Medicamento , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Ataque Isquêmico Transitório/tratamento farmacológico , Ataque Isquêmico Transitório/prevenção & controle , Ataque Isquêmico Transitório/terapia , Masculino , Pessoa de Meia-Idade , Especificidade de Órgãos , Paclitaxel/administração & dosagem , Paclitaxel/efeitos adversos , Recidiva , Estudos Retrospectivos , Sirolimo/administração & dosagem , Sirolimo/efeitos adversos , Stents/efeitos adversos , Acidente Vascular Cerebral/etiologia , Insuficiência Vertebrobasilar/prevenção & controle
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