Interventionelle Behandlung intrakranieller Gefäßstenosen mittels ballongestützter Angioplastie und Implantation unbeschichteter und medikamentenbeschichteter Stentsysteme

This paper presents the results of the interventional treatment of 40 patients of symptomatic high- to maximum-degree stenoses of the intracranial ACI, the ACM, the ACP, the BA and the VA carried out within three years at the Robert Janker Clinic at the Bonn Medical Center in Bonn, Germany and the Neuroradiological Ward of the Siegen County Hospital. There were a total of 43 interventions and the mean preinterventional degree of stenoses was 83.25%. MRI was carried out before and after intervention including diffusion weighting and a neurological examination. The findings of the neurological examination were retrospectively transferred to a standardised assessment during evaluation with the modified Rankin Scale. The technical success rate was in the region of 95.3%. We undertook 9 balloon-supported angioplasties and 32 stent implantations (26 uncoated stents and 6 sirolimus-coated stents). The medium degree of post-interventional stenoses was 11.39% (stent 4.68% and balloon-supported angioplasty 30.9%). There were new diffusion disorders after 16.3% of the interventions, major strokes in 3 cases (6.97%) and one minor stroke (2.33%) with slight neurological deterioration. The mortality was 2.33% and altogether there was average deterioration of 0.21 points in the Rankin Score. The rate of local complications (inguinal haematomas) was 4.65%. 65.1% of the patients treated came to the follow-up examination (DSA, MR angiography or CT angiography) and the average follow-up period was 7.1 months. There were haemodynamically relevant restenoses with 3 follow-up examinations (10.7%); two occurred after balloon-supported angioplasty and one after implanting an uncoated stent. All of the 6 patients that were given a sirolimus-coated stent had follow-up visits and we were not able to demonstrate a restenosis in any of these cases. In this paper, interventional treatment of intracranial stenoses proved to be superior to pure drug treatment in terms of prognosis. Stenting got better results than balloon-supported angioplasty in terms of the dilatation and restenosis frequency. Our results provide compelling arguments for drug-coated stents lowering the hazard of restenosis. We may logically assume from these results that patients with a high degree of symptomatic stenoses of the intracranial vessels should be treated interventionally with drug-coated stents.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2005

Author dc:creator

• Roth, Henrik Joachim

Contributors dc:contributor

• Reul, Jürgen

• info:eu-repo/classification/ddc/610
• Medizin
• intracraniale Stenose
• Stroke
• Stent

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-208196%22

OAI identifier oai:identifier

oai:publications.rwth-aachen.de:62097