Computed tomography angiography, perfusion computed tomography, and a drug-eluting stent for the treatment of in-stent restenosis of the middle cerebral artery

Kim, Seong-Rim; You, Seung-Hoon; Yoon, Won Ki; Kim, Young Woo; Kim, Sang‐Don; Park, Ik-Seong; Baik, Min-Woo

doi:10.3171/2009.8.jns081609

Cited by 3 publications

(2 citation statements)

References 32 publications

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“…Delayed acute stent thrombosis is, however, one of the issues with DES [13]. For intracranial indications, excellent follow-up results with DES have been reported [14], including the treatment of ISR after BMS deployment [15]. As a major drawback, DES are significantly less flexible than BMS, leaving many intracranial arteries just unreachable.…”

Section: Discussionmentioning

confidence: 99%

Recurrent In-Stent Restenosis in a Symptomatic Nonatherosclerotic M1 Plaque

et al. 2010

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Section: Discussionmentioning

confidence: 99%

Recurrent In-Stent Restenosis in a Symptomatic Nonatherosclerotic M1 Plaque

et al. 2010

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“…The optimal treatment strategy for intracranial ISR remains unclear. Endovascular treatment is a treatment option for severe or symptomatic ISR, but few reports have specifically focused on the safety and efficacy of its use for intracranial ISR 12 23 24. We therefore conducted this study to evaluate the periprocedural safety and long-term efficacy of endovascular therapy for intracranial ISR.…”

Section: Introductionmentioning

confidence: 99%

Outcome of endovascular recanalization for intracranial in-stent restenosis

Kang

Gao

et al. 2020

J NeuroIntervent Surg

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Background and purposeIn-stent restenosis (ISR) is one of the long-term adverse outcomes of endovascular angioplasty and stenting for symptomatic intracranial arterial stenosis. In this study, we try to evaluate the safety and efficacy of endovascular treatment for intracranial ISR.MethodsWe retrospectively collected patients with intracranial ISR who underwent endovascular treatment from June 2012 to August 2019 at a high-volume stroke center. Successful recanalization was defined as ≤30% residual stenosis. Stroke, myocardial infarction, and death after stenting within 30 days were used to evaluate periprocedural safety. Recurrent stroke in the territory of the culprit vessel and re-ISR in patients with clinical and vascular imaging follow-up data were used to evaluate the long-term outcome.Results32 patients (59.6±7.2 years old) with ISR were recruited, including 22 patients (68.8%) treated with balloon dilatation, 8 patients (25%) with stenting, and 2 patients (6.3%) with failed procedures. Successful recanalization was achieved in 71.9% (23/32) of patients. There was no stroke, myocardial infarction or death within 30 days after the procedure. Recurrent stroke was found in 10.7% (3/28) of the patients, and re-ISR was found in 42.1% (8/19) of the patients. The re-ISR rate was lower in patients with stenting than in those with balloon dilatation (0% vs 57.1%, p=0.090), and in patients with successful recanalization than in those with unsuccessful recanalization (33.3% vs 75.0%, p=0.352), but with no statistically significant difference.ConclusionsThe periprocedural safety of endovascular treatment for intracranial ISR may be acceptable, but the long-term rates of recurrent stroke and re-ISR remain at high levels.

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Association of occlusion time with successful endovascular recanalization in patients with symptomatic chronic intracranial total occlusion

Yang

Kang

Gao

et al. 2022

Journal of Neurosurgery

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OBJECTIVE Endovascular treatment is one of the choices for symptomatic chronic intracranial total occlusion (CITO); however, its safety and efficacy remain unclear. The present study was performed to evaluate the safety and long-term outcome of endovascular treatment for CITO at a high-volume stroke center. METHODS Data about patients with symptomatic CITO who received endovascular treatment were retrospectively collected. Technique success was regarded as ≤ 30% residual stenosis. Periprocedural complications within 30 days were used to evaluate safety. Baseline characteristics and lesion features were compared between patients with successful recanalization and those with recanalization failure. Stroke recurrence and in-stent restenosis (ISR) of the culprit arteries during follow-up were used to evaluate long-term efficacy. RESULTS From June 2012 to September 2019, 117 patients (mean ± SD age 55.8 ± 9.6 years) were included. The successful recanalization rate was 82.9% (97/117 patients). The combined rate of periprocedural stroke, myocardial infarction, and death was 8.5% (10/117). Compared with patients with successful recanalization, patients with recanalization failure had longer occlusion time and longer lesion length (27.0 mm vs 15.4 mm, p = 0.001). In the median 23.0-month clinical follow-up period, recurrent stroke occurred in 12.6% (11/87) of patients with successful recanalization. In the median 5-month imaging follow-up period, ISR was detected in 26.6% (21/79) of patients. CONCLUSIONS Endovascular treatment was relatively safe for patients with symptomatic CITO. Shorter occlusion time and shorter lesion length may be associated with higher recanalization rate. The rates of stroke recurrence and symptomatic ISR were acceptable but need to be confirmed in future studies.

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Computed tomography angiography, perfusion computed tomography, and a drug-eluting stent for the treatment of in-stent restenosis of the middle cerebral artery

Cited by 3 publications

References 32 publications

Recurrent In-Stent Restenosis in a Symptomatic Nonatherosclerotic M1 Plaque

Recurrent In-Stent Restenosis in a Symptomatic Nonatherosclerotic M1 Plaque

Outcome of endovascular recanalization for intracranial in-stent restenosis

Association of occlusion time with successful endovascular recanalization in patients with symptomatic chronic intracranial total occlusion

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