Current Cardiology Reports

, Volume 12, Issue 1, pp 20–28

Indications and Applications of Arterial Stents for Stroke Prevention in Atherosclerotic Intracranial Stenosis

  • Jeremy D. Fields
  • Kenneth C. Liu
  • Stanley L. Barnwell
  • Wayne M. Clark
  • Helmi L. Lutsep
Article

DOI: 10.1007/s11886-009-0070-4

Cite this article as:
Fields, J.D., Liu, K.C., Barnwell, S.L. et al. Curr Cardiol Rep (2010) 12: 20. doi:10.1007/s11886-009-0070-4

Abstract

Intracranial stenosis accounts for 8–10% of all ischemic strokes in North America, a frequency slightly less than that of extracranial carotid stenosis. Among patients presenting with transient ischemic attack or stroke due to intracranial stenosis, the risk of recurrent stroke in the first year after initial symptoms is about 14%. Those with high-risk features (recent stroke and severe stenosis) have up to a 23% rate of recurrent stroke in the year after their initial event. Angioplasty with stenting has emerged as a potential treatment strategy, particularly in high-risk patients, although evidence is currently limited to uncontrolled prospective trials and retrospective case series. In this article, we critically review the clinical results supporting the use of stenting and highlight some key considerations in the application of this technology, including patient selection, procedural management, technical issues, and risk factors for complications and in-stent restenosis.

Keywords

StrokeIntracranial stentIntracranial angioplastyIntracranial stenosisIntracranial atherosclerotic diseaseStroke prevention

Clinical Trial Acronyms

GESICA

Groupe d’Etude des Stenoses Intra-Craniennes Atheromateuses Symptomatiques

SAMMPRIS

Stenting vs. Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis

SSYLVIA

Stenting of Symptomatic Atherosclerotic Lesions in the Vertebral or Intracranial Arteries

VISSIT

Vitesse Intracranial Stent Study for Ischemic Therapy

WASID

Warfarin-Aspirin Symptomatic Intracranial Disease

WFITN

World Federation of Interventional Therapeutic Neuroradiology

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Jeremy D. Fields
    • 1
  • Kenneth C. Liu
    • 2
  • Stanley L. Barnwell
    • 2
  • Wayne M. Clark
    • 1
  • Helmi L. Lutsep
    • 1
  1. 1.Departments of Neurology and Interventional NeuroradiologyOregon Health & Science UniversityPortlandUSA
  2. 2.Departments of Neurosurgery and Interventional NeuroradiologyOregon Health & Science UniversityPortlandUSA