Cerebral Nitinol Stenting in Progressive Stroke and in Crescendo TIAs

Journal of Neurological Surgery. Part A, Central European Neurosurgery
Or Cohen-Inbar, Yaaqov Amsalem

Abstract

Acute ischemic stroke (AIS) is the third leading cause of death. Arterial stenosis is a common cause of stroke, with a high risk of recurrent stroke. Treatment guidelines for AIS and transient ischemic attack (TIA) are still under debate. Treatment guidelines for progressive stroke or crescendo TIAs do not exist. Percutaneous transluminal angioplasty and stenting (PTAS) is an increasingly attractive treatment option, whose efficacy is yet to be proven. However, stent placement poses both short- and long-term risks such as immediate ischemic events, in-stent stenosis, and stent breakage. Thus the choice of stent type is critical. We report our experience with the LEO + (Balt Extrusion, Montmorency, France) nitinol flexible self-expanding stent for the treatment of progressive cerebrovascular accident or crescendo TIAs. Twelve patients, presenting with a clinical picture of a crescendo TIA or progressive stroke in evolution not halted by optimal medical care, were treated. Patients had a corresponding major cerebral arterial narrowing and evidence of cerebral infarction on imaging. Patients were followed clinically and radiographically. Twelve patients 17 to 80 years of age were treated during the study period (20 months). Sixtee...Continue Reading

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