Safety and efficacy of intracranial stenting for acute ischemic stroke beyond 8 h of symptom onset

Andrew R. Xavier, Ambooj Tiwari, Natasha Purai, Mahmoud Rayes, Paritosh Pandey, Amit Kansara, Sandra Narayanan, Seemant Chaturvedi

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Objective: To report our experience with stent supported intracranial recanalization for acute ischemic stroke beyond 8 h of symptoms onset. Background: Acute ischemic stroke (AIS) therapy is often limited to an 8 h window using mechanical means. However, recent reports have shown delayed recanalization beyond 8 h might be a viable option in a subset of patients. Methods: A retrospective review was performed of our AIS database for patients who underwent stent supported intracranial recanalization beyond 8 h of symptom onset. Clinical and angiographic data were reviewed. Outcome was measured using modified Rankin Scale (mRS) scores at 30 and 90 days. Results: 12 patients (11 men and one woman) underwent delayed stenting for AIS. Mean age was 49 years (range 37-73) and mean National Institutes of Health Stroke Scale was 17 (range 8-29, median 15). Mean time from stroke onset to intervention was 66.1 h (range 10-168 h, median 46 h). 10 patients presented with a Thrombolysis in Myocardial Infarction (TIMI) score of 0 and the remaining two had a TIMI of 1. Recanalized vessels included: left middle cerebral artery (n=6), basilar trunk (n=2), vertebrobasilar junction (n=3) and internal carotid artery (ICA)-T (n=1). Four patients had prior attempts of embolectomy/thrombolysis using mechanical and chemical means. Stents used included: six balloon mounted stents, five Wingspan and one Enterprise self-expanding intracranial stent. Recanalization, defined as a TIMI score of 2 or more, was achieved in 11 patients. Two patients (17%) had intracranial hemorrhage. Thirty day mRS of ≤3 was achieved in six patients (50%). Seven patients (58%) had a 90 day mRS of ≤2. Conclusion: Stent supported intracranial recanalization is a safe and feasible approach in a selective group of patients presenting with acute ischemic stroke beyond 8 h of symptom onset.

Original languageEnglish (US)
Pages (from-to)94-100
Number of pages7
JournalJournal of neurointerventional surgery
Volume4
Issue number2
DOIs
StatePublished - Mar 1 2012
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Fingerprint Dive into the research topics of 'Safety and efficacy of intracranial stenting for acute ischemic stroke beyond 8 h of symptom onset'. Together they form a unique fingerprint.

  • Cite this