Background and Purpose-Rapid and safe recanalization of occluded intracranial arteries in acute ischemic stroke (AIS) is challenging. Newly available self-expanding intracranial atherosclerotic stents (SEIS), which can be deployed rapidly and safely, make acute stenting an option for treating AIS. We present the feasibility of this technique. Methods-A retrospective analysis evaluated procedural protocols and clinical response to treatment in patients with AIS treated with SEIS. Descriptive statistics are presented with initial and follow-up National Institutes of Health Stroke Scale and modified Rankin Score. Results-Nine patients with AIS underwent acute SEIS placement. There was successful deployment of the Neuroform (nϭ4) and Wingspan (nϭ4/5) stents in the M1/M2 (nϭ5) and M3 (nϭ1) middle cerebral artery segments, intracranial internal carotid artery (one of 2), and intracranial vertebrobasilar junction (one). The Merci clot retrieval system (Concentric Medical) has been studied in a series of trials and been shown to have a 54% rate of TIMI 2/3 recanalization rate. 8 Until recently, intracranial stenting was limited to off-label use of balloon-mounted stents designed for cardiac circulation. These stents are poor tools for treating intracranial disease because they are rigid, making navigation in the tortuous intracranial circulation difficult. 9 The recently available self-expanding intracranial stents (SEIS) allow acute stenting as an option in AIS that is refractory to conventional management. 10 -12 We present our experience in the feasibility of SEIS for the treatment of AIS. MethodsAfter obtaining Institutional Review Board approval, the neurointerventional database at Medical College of Wisconsin was reviewed from July 2005 to October 2007 and patients with AIS in whom stent-assisted recanalization was performed were identified. Patients or their legal representatives gave prior informed consent for chemical or mechanical thrombolysis, including clot retrieval devices, angioplasty, and/or stenting. SEIS was performed in AIS within 8 hours of symptom onset with a National Institutes of Health Stroke Scale score Ն10 and cranial CT imaging without ICH or clear early cerebral infarction more than or equal to one third of the vessel distribution with angiographic occlusion (length 14 mm) amenable to SEIS (at least 3-mm landing zone pre-and postclot).Modified Rankin Scores (mRS), ICH, mortality, and vessel recanalization data were collected. Recanalization was assessed by 2 of the authors (OOZ and BFF), who were unaware of the study design at the time of interpretation using the accepted TICI/TIMI grading systems. 13 InterventionAfter the clot was identified, a 2000-unit heparin intravenous bolus followed by a 450-unit/hr intravenous infusion was administered throughout the procedure (IMS-III protocol). Stent placement was attempted after standard AIS intervention failure (no recanalization after 1 hour of chemical thrombolysis; mean dose, 9 mg; range, 6 to 15 mg; one Merci device use; or Ն70% residual ste...

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