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Updated: Jun 1, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Applications of stenting for intracranial atherosclerosis
1Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia 22908, USA.
Insights
Intracranial atherosclerosis remains a challenge, with high stroke rates despite medical therapy. Stenting offers new hope, but a randomized trial is needed to compare intracranial stenting versus medical management.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Vascular Surgery
Background:
- Intracranial atherosclerosis (ICAS) poses significant therapeutic challenges, leading to high stroke rates even with maximal medical therapy, particularly in severe symptomatic cases.
- Traditional surgical and endovascular interventions have shown limited efficacy due to high complication rates, necessitating novel treatment approaches.
Purpose of the Study:
- To review and compare the technical and clinical outcomes of various intracranial stenting systems used for treating intracranial atherosclerosis.
- To evaluate the current evidence for stenting in intracranial stenosis and identify areas for future research.
Main Methods:
- A review of prospective and retrospective clinical studies involving different intracranial stenting systems, including NEUROLINK, Taxus, Cypher, Wingspan, Apollo, and Pharos.
- Comparison of technical success rates and clinical results reported for each stent system.
Main Results:
- The Wingspan stent demonstrated a potential advantage in technical success compared to other systems.
- Clinical follow-up data for the Wingspan stent are currently insufficient to accurately assess its complication rates relative to other stents.
- Varied technical and clinical results were reported across the different stenting systems evaluated.
Conclusions:
- Intracranial stenting represents a promising avenue for treating intracranial atherosclerosis, but current data are limited.
- Further research, specifically randomized prospective trials comparing intracranial stenting directly with medical therapy, is essential to establish definitive treatment guidelines.
Abstract:
Intracranial atherosclerosis presents a therapeutic challenge to medical and surgical physicians alike. Despite maximal medical therapy, the stroke rate from this disease is still high, especially when arterial stenosis is severe and patients are symptomatic. Open surgical therapy has yet to be shown to be a more efficacious treatment than medical therapy alone, largely due to the relatively high rates of perioperative complications. Angioplasty has a similar fate, with the risk of periprocedural complications outweighing the overall benefit of treatment. With the advent of stents for use in intracranial vasculature, new hope has arisen for the treatment of intracranial atherosclerosis. The NEUROLINK system, the drug-eluting stents Taxus and Cypher, the flexible Wingspan stent, the Apollo stent, and the Pharos stent have all been used in various prospective and retrospective clinical studies with varying technical and clinical results. The authors' objective is to review and loosely compare the data presented for each of these stenting systems. While the Wingspan stent appears to have somewhat of an advantage with regard to technical success in comparison with the other stenting systems, the clinical follow-up time of its studies is too short to properly compare its complication rates with those of other stents. Before we continue to move forward with stenting for intracranial stenosis, a randomized prospective trial is ultimately needed to directly compare intracranial stenting to medical therapy.
