1Rosario Papa, 2Ayman Al-Sibaie, 1Derk Krieger, 2Suhail Al-Rukn

1Mediclinic City Hospital, Dubai, United Arab Emirates; 2Raschid Hospital, Dubai, United Arab Emirates

 

Background:

Intracranial vascular stenosis became a significant cause of acute ischemic stroke and recently the prevalence of this condition has been found to be 31% in an elderly population with common cardiovascular risk factors, with a percentage of vascular stenosis> 50% in 9% of cases.

In this short series  we report optimal technical success (100%) of endovascular treatment of intracranial symptomatic vascular stenosis employing a novel technique as low profile stent ( neuroform atlas or Credo) in combination with Neurospeed balloon.

Material(s) and Method(s):

3 patients were admitted to our stroke units with recurrent TIA or stroke. All 3 patients had a history of known intracranial stenosis of over 75%, treated in the previous months with the best medical therapy (double antiplated and statin)

Before Endovascular Treatment (EVT) procedure, informed consent was obtained; if the patient was unable to give explicite consent, the accompanying relatives were in any case made aware of the procedure.

Clinical status at follow up was assessed by an experienced neurologist and neuroradiologist, who jointly evaluated clinical and imaging data.

All endovascular procedures were performed in our 2  center institution under general anesthesia and by one or two senior interventional neuroradiologists.

The procedures were all performed in triaxial technique using a 6F long sheath (Neuron Max 088 Penumbra, USA) .All patient received preliminary angioplasty with neuroSpeed  ballon catheter(acandis) .

The intracranial stents ( 1 neuroform atlas , 2 Credo ) were released by NeuroSpeed ballon catheter.

All patients were subsequently assessed with a neurological examination.

Result(s):

In all patients the procedure was successful without any complications.

Immediate follow-up demonstrated good size of the vessels with complete resolution of the stenosis.

No restenosis in the 1 month follow up.

All patients made a full recovery within one week.

Conclusion:

In our preliminary  experience we obtained encouraging clinical and angiographic results in endovascular treatment of IS due to atheromatous disease  with a novel intracranial stenting technique with Neuroform Atlas stent  or Credo stent with  Neurospeed PTA balloon catheter.

More data are mandatory to confirm and evaluate the real clinical benefit of endovascular treatment of IS and specifically the novel technique presented, Especially if, in the near future we would like to start treating patients with severe symptomatic intracranial stenosis, before the best medical has failed.