C. Vetta 1, S. Horner 1, H. Deutschmann 2, T. Gattringer 1, K. Niederkorn 1
1 Department of Neurology,
2 Department of Radiology, Medical University – Graz, Austria

Objective: Stenoses of intracranial arteries (IAS)are responsible for 10% - 15% of all ischemic strokes.The purpose of the present study was to retrospectively identify the outcome of endovascular treatments of IAS with Stent-PTA performed at the University Hospital Graz during the period of 2003 to 2012.

Material and Methods: Data from all patients who underwent interventional procedures during the period 2003–2012, caused by a symptomatic (transient ischemic attack or stroke) stenosis of a major intracranial artery, were extracted from a stent data base. Technical success, clinical outcome, the rate of instent restenosis (ISR) and recurrent stroke as well as prognosis were defined as primary objectives. Examinations were at 24 hours and 6 months after the procedure, as well as the last consultation of the stroke outpatient clinic.

Results: 89 patients (20 female, 69 male; mean age 67.3 years) with 93 symptomatic intracranial stenoses were treated by interventional procedures. Technical success rate was 98,9%. After a mean follow - up time of 2.6 years, 78.8% showed a good clinical outcome according to the modified Rankin Scale (mRS) scores of 0–2, while 15.7% were disabled (mRS 3–5). 5.6% deceased, none of them within the first 30 days after the initial intervention. A 24-hours post procedure ISR – rate of 7.5% (7 patients), a 6-months rate of 16.5% (14 patients) and a long-term rate of 13.0% (12 patients) was diagnosed. Ipsilateral stroke or transient ischemic attack occurred in 3.2% during the first 24 hours, in in 6.5% within 30 days, and in 15.1% until 12 months after intervention.

Discussion: Endovascular treatment of symptomatic IAS showed high rates of technical success and an acceptable number of instent restenosis and periprocedural ipsilateral stroke. However, the choice for optimal treatment has to be based on individual decision making by an experienced multidisciplinary team.

Key words: intracranial artery stenosis, restenosis, stent pta, ultrasound.

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