Use of the Enterprise Intracranial Stent for Revascularization of Large Vessel Occlusions in Acute Stroke

Kulcsar, Zsolt; Bonvin, Christophe; Lövblad, Karl-Olof; Gory, B.; Yilmaz, Hasan; Sztajzel, Roman; Ruefenacht, Daniel André

doi:10.1007/s00062-010-9024-x

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Title		Use of the Enterprise Intracranial Stent for Revascularization of Large Vessel Occlusions in Acute Stroke
Authors		Kulcsar, Zsolt Bonvin, Christophe Lövblad, Karl-Olof Gory, B. Yilmaz, Hasan Sztajzel, Roman Ruefenacht, Daniel André
Published in		Klinische Neuroradiologie. 2010, vol. 20, no. 1, p. 54-60
Collection		Open Access - Licence nationale Springer
Abstract		BACKGROUND AND PURPOSE: Major cerebral thromboembolism often resists recanalization with currently available techniques. The authors present their initial experience with a self-expanding stent for use in intracranial vascular reconstruction, permitting immediate recanalization of acute thromboembolic occlusions of the anterior circulation. PATIENTS AND METHODS: Patients treated with the Cordis Enterprise self-expanding intracranial stent system for acute thromboembolic occlusion of the major anterior cerebral arteries were included. Treatment comprised systemic and intraarterial thrombolysis, mechanical thrombectomy, and stent placement. Stent deployment, recanalization rate by means of Thrombolysis In Cerebral Infarction (TICI) scores and the clinical outcome were all assessed. RESULTS: Six patients presenting with acute carotid T (n = 2) or proximal middle cerebral artery occlusion (n = 4) were treated. The mean National Institutes of Health Stroke Scale (NIHSS) score at presentation was 14; the mean age was 57 years. Successful stent deployment and immediate recanalization were achieved in all six with a TICI score of >/= 2. Neither distal emboli nor any procedure-related complications were encountered. One patient developed symptomatic intracerebral hemorrhage and two patients needed decompressive craniectomy after treatment. The mean NIHSS score at 10 days was 10, but only one patient showed a complete recovery at 3 months. CONCLUSION: Intracranial placement of the Enterprise self-expanding stent has proven to be feasible and efficient in achieving immediate recanalization of occluded main cerebral arteries. The use of antiplatelet therapy after treatment may, however, increase the risk of reperfusion intracerebral hemorrhage.
Identifiers		DOI: 10.1007/s00062-010-9024-x PMID: 20229205
Full text		Article (Published version) - Free access Other version: http://www.springerlink.com/content/q03p78220v735qx0/fulltext.pdf
Structures		Faculté de médecine / Section de médecine clinique / Département des neurosciences cliniques Faculté de médecine / Section de médecine clinique / Département de radiologie et informatique médicale
Research group		Ischémie cérébrale et connectivité (801)
Citation (ISO format)		KULCSAR, Zsolt et al. Use of the Enterprise Intracranial Stent for Revascularization of Large Vessel Occlusions in Acute Stroke. In: Klinische Neuroradiologie, 2010, vol. 20, n° 1, p. 54-60. doi: 10.1007/s00062-010-9024-x https://archive-ouverte.unige.ch/unige:21057