Enterprise stent for symptomatic complex intracranial atherosclerotic stenosis: safety and efficiency

Purpose: To evaluate the safety and efficacy of Enterprise stent in the treatment of symptomatic complex intracranial atherosclerotic stenosis. Methods and materials: 20 complex cases among 53 patients with symptomatic ischemic stroke who were treated with balloon angioplasty and enterprise stents in Department of Neuro-interventional Radiology, The First Affiliated Hospital of Zhengzhou University from Jan. 2014 to Dec. 2017 were retrospectively enrolled in this study. Diagnostic criteria for complex intracranial atherosclerotic stenosis were as follows: 1) intracranial atherosclerotic stenosis was ≥70% confirmed by digital subtraction angiography (DSA) using the formulas described by the Warfarin Aspirin Symptomatic Intracranial Disease (WASID) method; 2) length of lesion was >10 mm. Basic characteristics of target lesions, technical success rate, perioperative safety, follow-up outcomes were investigated. Results: 20 patients were enrolled in this study, including 15 males and 5 females from 44 to 70 years old with an average age of 57.20 ± 9.25. 20 lesions were treated with 20 enterprise stents. The average preoperative and postoperative residual stenosis was reduced from (77.45 ± 8.44)% to (24.89 ± 16.61)%. The successful rate of operation was 100%. Among the perioperative complications, only 1 case (5%) experienced perforating branch event. The average clinical follow-up period was 13.15 ± 11.33 months (time range: 5-38). There were no ischemic events, no bleeding events and no various causes of death during the follow-up period. 8 lesions (40.0%) underwent DSA follow-up examinations and 12 lesions (60.0%) were checked by CT angiography during the follow-up period. 3 lesions (15.0%) developed ISR without any cerebral ischemia symptoms. Conclusion: This retrospective, single-center study suggests that enterprise stent is effective in the treatment of symptomatic complex intracranial atherosclerotic stenosis with less perioperative complications. Prospective, multicenter, randomized controlled trials are expected.