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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

12.4K

Stenting with Acclino (flex) for symptomatic intracranial stenosis as secondary stroke prevention

Lukas Meyer1, Hannes Leischner2, Goetz Thomalla3

  • 1Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany lu.meyer@uke.de.

Journal of Neurointerventional Surgery
|March 4, 2020
PubMed

Insights

Elective intracranial stenting (eICS) using a novel stent and balloon catheter combination showed acceptable safety and efficacy for secondary stroke prevention in patients with symptomatic intracranial stenosis. Further research is needed to optimize antithrombotic strategies and manage in-stent restenosis.

Area of Science:

  • Neurology
  • Interventional Neuroradiology
  • Cardiovascular Medicine

Background:

  • Symptomatic intracranial stenosis carries a high risk of stroke recurrence, even with optimal medical management.
  • Previous studies on intracranial stenting used older devices, necessitating evaluation of newer technologies.
  • Elective intracranial stenting (eICS) is reserved for a select group of high-risk patients.

Purpose of the Study:

  • To evaluate the safety and efficacy of a novel device combination for eICS in patients with symptomatic intracranial stenosis.
  • To report periprocedural complications and long-term outcomes, including stroke, death, hemorrhage, and stent patency.

Main Methods:

  • Retrospective analysis of 76 patients from three high-volume stroke centers treated with Acclino (flex) stent and NeuroSpeed balloon catheter.
  • Endpoints included periprocedural stroke or death, intracranial hemorrhage, and stent patency at follow-up.
  • Safety assessment encompassed asymptomatic/symptomatic intracranial hemorrhage and adverse events.

Main Results:

  • The periprocedural stroke or death rate was 6.5% (2.6% fatal, 3.9% non-fatal).
  • Asymptomatic intracranial hemorrhage occurred in 5.2% of patients.
  • Follow-up revealed 25% in-stent restenosis, with 11.6% requiring repeat angioplasty.

Conclusions:

  • eICS with the Acclino (flex)/NeuroSpeed system appears safe for symptomatic intracranial stenosis, offering an endovascular option for secondary stroke prevention.
  • Further studies are required to confirm these findings and optimize management of antithrombotic strategies and in-stent restenosis for long-term patency.
Abstract

Keywords:
interventionstenosisstentstroke

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