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Emergent self-expanding stent placement for acute intracranial or extracranial internal carotid artery dissection with significant hemodynamic insufficiency.

Authors
 P. Jeon  ;  B.M. Kim  ;  D.I. Kim  ;  Y.S. Shin  ;  K.H. Kim  ;  S.I. Park  ;  D.J. Kim  ;  S.H. Suh 
Citation
 AMERICAN JOURNAL OF NEURORADIOLOGY, Vol.31(8) : 1529-1532, 2010 
Journal Title
 AMERICAN JOURNAL OF NEURORADIOLOGY 
ISSN
 0195-6108 
Issue Date
2010
MeSH
Acute Disease ; Adult ; Carotid Artery, Internal, Dissection/diagnostic imaging ; Carotid Artery, Internal, Dissection/physiopathology* ; Carotid Artery, Internal, Dissection/therapy* ; Cerebral Angiography ; Cerebral Revascularization/instrumentation* ; Cerebral Revascularization/methods ; Cerebrovascular Circulation* ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Severity of Illness Index ; Stents* ; Treatment Outcome ; Young Adult
Abstract
BACKGROUND AND PURPOSE: ICAD with hemodynamic insufficiency may present with either fulminant infarct or with progressive neurologic deterioration. The purpose of this study was to evaluate the safety and efficacy of emergent self-expanding stent placement for acute intracranial or extracranial ICAD with significant hemodynamic insufficiency. MATERIALS AND METHODS: Eight patients (7 men and 1 woman; age range, 20-55 years; NIHSS score, 5-21) underwent emergent self-expanding stent placement for treatment of significant hemodynamic insufficiency due to acute ICAD. The safety and efficacy of emergent self-expanding stent placement were retrospectively evaluated. RESULTS: All patients presented with progressive (n = 6) or fluctuating (n = 2) neurologic deficits and revealed markedly decreased perfusion on CT or MR perfusion studies. Conventional angiography revealed acute occlusion (n = 2) or critical stenosis (n = 6) in intracranial (n = 3) or extracranial (n = 5) carotid arteries with a lack of sufficient collaterals. Stent placement was successful in all patients without any procedure-related complications. In all patients, hemodynamic insufficiency was corrected immediately after stent placement, and neurologic symptoms were completely resolved during several days. Mean improvement of the NIHSS score between baseline and discharge was 11.6 (range, 5-21). All patients remained neurologically intact (mRS, 0) during clinical follow-up for a mean of 21 months (range, 8-50 months). Angiographic follow-up was available for 6 patients at 3-12 months. None of the 6 patients revealed residual or in-stent restenosis. CONCLUSIONS: Self-expanding stent placement is a safe and effective option for selected patients with significant hemodynamic insufficiency due to acute intracranial or extracranial ICAD.
Files in This Item:
T201002603.pdf Download
DOI
10.3174/ajnr.A2115
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Ik(김동익)
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
Park, Sung Il(박성일)
Suh, Sang Hyun(서상현) ORCID logo https://orcid.org/0000-0002-7098-4901
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101639
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