Initial Experience of Emergent Intracranial Stenting for Acute Steno-Occlusive Lesions: Preliminary Experience from A Single-Center

Within 6 hours of a cerebral major artery occlusion, thrombus retrieval in the anterior circulation can be performed in addition to intravenous recombinant tissue-type plasminogen activator therapy. However, even if revascularization is achieved, reocclusion can occur in cases involving atherosclerotic lesions. Typically, we use percutaneous transluminal angioplasty for these lesions, but if no improvement occurs, we place an intracranial stent. We examined 10 previous cases treated with stents at our hospital; stents were successfully inserted in 9 cases, and revascularization was achieved in all cases. Postoperative cerebral infarctions occurred at the perforating branch in 3 cases. In 1 case, stent occlusion occurred 1 month after stent placement possibly because of an ineffective antiplatelet agent. In the SAMMPRIS trial, intracranial stent placement led to worse results compared to that of medical therapy. For this reason, intracranial stenting was used to avoid resistance to medical therapy or complications from surgical procedures. If revascularization was not promptly achieved, patient outcomes with cerebral major artery occlusion were poor. In the acute phase, intracranial stent placement may be useful for severe stenosis after recanalization therapy or after percutaneous transluminal angioplasty.