Related Experiment Video
Updated: Aug 10, 2026
Vascular Gene Transfer from Metallic Stent Surfaces Using Adenoviral Vectors Tethered through Hydrolysable Cross-linkers
Published on: August 12, 2014
Pharos neurovascular intracranial stent: elective use for a symptomatic stenosis refractory to medical therapy
J Mocco1, Ziad Darkhabani, Elad I Levy
1Department of Neurosurgery, Toshiba Stroke Research Center, University at Buffalo, State University of New York, Buffalo, NY, USA.
Insights
Medically managed patients with symptomatic intracranial stenosis face high stroke risks. The novel Pharos Neurovascular Stent System shows promise in treating this condition, achieving excellent angiographic results with no restenosis.
Area of Science:
- Neuroendovascular interventions
- Cerebrovascular disease management
- Medical device innovation
Background:
- Symptomatic intracranial stenosis carries a significant annual stroke risk (7-11%) despite medical management.
- Early endovascular treatments using balloon-mounted coronary stents had limitations in accessing tortuous intracranial vessels.
- Self-expanding stents offered improved flexibility but showed high midterm restenosis rates.
Observation:
- The Pharos Neurovascular Stent System, a balloon-expandable stent on a rapid-exchange PTA catheter, was developed for intracranial applications.
- Initial use of the Pharos stent resulted in excellent angiographic outcomes with 0% residual stenosis.
- A single patient treated with the Pharos stent remained symptom-free at 3 months with no in-stent stenosis.
Findings:
- The Pharos stent achieved superior angiographic results compared to previous stent types.
- The device demonstrated a favorable safety profile with no associated morbidity in this case.
- The patient experienced a complete resolution of symptoms and maintained patency post-procedure.
Implications:
- The Pharos stent may offer a valuable alternative for patients with medically refractory intracranial stenosis.
- Further research is warranted to confirm the long-term efficacy and safety of the Pharos stent.
- This technology could potentially reduce stroke risk in patients with complex intracranial stenosis.
Abstract:
The Warfarin-Aspirin Symptomatic Intracranial Disease study investigators demonstrated that medically managed patients with symptomatic intracranial stenosis experience a 7-11% annual stroke risk. Early treatment efforts utilized balloon-mounted coronary stents, which provided excellent angiographic results (postprocedure stenoses <10%), versus percutaneous transluminal angioplasty (PTA) alone (40%). However, the rigidity of balloon-mounted coronary stents provided limited access to the tortuous cerebrovasculature. Self-expanding stents became available for intracranial stenosis treatment in 2002. With increased flexibility, immediate results were encouraging (approximately 30% residual stenosis). However, midterm results have demonstrated disappointingly high rates of restenosis. To address these issues, the Pharos Neurovascular Stent System (Pharos, Micrus Endovascular, San Jose, CA) was developed. The Pharos is a balloon-expandable stent mounted on a rapid-exchange PTA catheter especially designed for intracranial endovascular applications. Utilizing the Pharos, we obtained an outstanding angiographic result (0% residual stenosis), with no associated morbidity. The patient was discharged home on postprocedure day 1 and remained symptom-free, with no in-stent stenosis, 3 months later. Our experience with the Pharos supports early literature suggesting that this stent may be a valuable treatment option for patients with medically refractory intracranial stenosis.
