The modified bose method for the endovascular treatment of intracranial atherosclerotic arterial stenoses using the enterprise stent

Z. Vajda, Elisabeth Schmid, Thomas Güthe, Christoph Klötzsch, Alfred Lindner, Ludwig Niehaus, Wolfgang Sperber, Jan Peters, Guy Arnold, Hansjörg Bäzner, Hans Henkes

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

BACKGROUND: Balloon dilatation and deployment of a self-expanding stent is a safe treatment for intracranial atherosclerotic stenoses. The significant recurrence rate might be related to the high radial force of the Wingspan stent. OBJECTIVE: To evaluate the procedural safety and stenosis recurrence rate by the use of a stent with reduced radial force (Enterprise). METHODS: Two hundred nine atherosclerotic stenoses (189 patients) were treated (median age, 68 years; 132 male) in a single center. Lesion locations included internal carotid artery (n = 27), middle cerebral artery (n = 62), vertebral artery (n = 64), basilar artery (n = 55), and posterior cerebral artery (n = 1). Pre-and postmedication included acetylsalicylic acid and Clopidogrel for at least 12 months. Preprocedural and follow-up examinations included magnetic resonance imaging (MRI), neurological assessment, and digital subtraction angiography (6, 12, 26, and 52 weeks). Data registry included age, sex, normal vessel diameter, degree of stenosis, residual stenosis after stent, minimal in-stent diameter, and occurrence of ischemic symptoms during follow-up. RESULTS: Median pre-and postprocedural stenosis rate was 65.4 ± 1% vs 25.1 ± 1%. Technical success rate was 100%. Major procedural complications occurred in 16 patients (8.1%). Combined neurological morbidity and mortality rate at 30 days was 2 patients (0.9%). In 174 stenoses (83%) angiographic follow-up was obtained (mean, 10.2 months). A restenosis (>50%) was observed in 43 (24.7%) cases after 4.2 months (mean) with 4 (9.3%) symptomatic lesions. Incidence of recurrent ischemia related to the stented artery was 2.2% during 10.2 months of mean follow-up. CONCLUSION: Undersized balloon angioplasty and deployment of an Enterprise stent is safe and effective for intracranial stenoses. Follow-up results were equal to or better than those reported for bare-metal balloon-expandable or self-expanding stents and yielded excellent protection from recurrent ischemia.

Original languageEnglish
Pages (from-to)91-101
Number of pages11
JournalNeurosurgery
Volume70
Issue number1
DOIs
Publication statusPublished - Jan 2012

Fingerprint

Stents
Pathologic Constriction
clopidogrel
Therapeutics
Ischemia
Posterior Cerebral Artery
Recurrence
Basilar Artery
Digital Subtraction Angiography
Balloon Angioplasty
Vertebral Artery
Middle Cerebral Artery
Internal Carotid Artery
Aspirin
Registries
Dilatation
Arteries
Metals
Magnetic Resonance Imaging
Morbidity

Keywords

  • Atherosclerosis
  • Endovascular
  • Enterprise
  • Intracranial stenosis
  • Stent

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

The modified bose method for the endovascular treatment of intracranial atherosclerotic arterial stenoses using the enterprise stent. / Vajda, Z.; Schmid, Elisabeth; Güthe, Thomas; Klötzsch, Christoph; Lindner, Alfred; Niehaus, Ludwig; Sperber, Wolfgang; Peters, Jan; Arnold, Guy; Bäzner, Hansjörg; Henkes, Hans.

In: Neurosurgery, Vol. 70, No. 1, 01.2012, p. 91-101.

Research output: Contribution to journalArticle

Vajda, Z, Schmid, E, Güthe, T, Klötzsch, C, Lindner, A, Niehaus, L, Sperber, W, Peters, J, Arnold, G, Bäzner, H & Henkes, H 2012, 'The modified bose method for the endovascular treatment of intracranial atherosclerotic arterial stenoses using the enterprise stent', Neurosurgery, vol. 70, no. 1, pp. 91-101. https://doi.org/10.1227/NEU.0b013e31822dff0f
Vajda, Z. ; Schmid, Elisabeth ; Güthe, Thomas ; Klötzsch, Christoph ; Lindner, Alfred ; Niehaus, Ludwig ; Sperber, Wolfgang ; Peters, Jan ; Arnold, Guy ; Bäzner, Hansjörg ; Henkes, Hans. / The modified bose method for the endovascular treatment of intracranial atherosclerotic arterial stenoses using the enterprise stent. In: Neurosurgery. 2012 ; Vol. 70, No. 1. pp. 91-101.
@article{f6df27c8a0f84a4887c1a781c36493ed,
title = "The modified bose method for the endovascular treatment of intracranial atherosclerotic arterial stenoses using the enterprise stent",
abstract = "BACKGROUND: Balloon dilatation and deployment of a self-expanding stent is a safe treatment for intracranial atherosclerotic stenoses. The significant recurrence rate might be related to the high radial force of the Wingspan stent. OBJECTIVE: To evaluate the procedural safety and stenosis recurrence rate by the use of a stent with reduced radial force (Enterprise). METHODS: Two hundred nine atherosclerotic stenoses (189 patients) were treated (median age, 68 years; 132 male) in a single center. Lesion locations included internal carotid artery (n = 27), middle cerebral artery (n = 62), vertebral artery (n = 64), basilar artery (n = 55), and posterior cerebral artery (n = 1). Pre-and postmedication included acetylsalicylic acid and Clopidogrel for at least 12 months. Preprocedural and follow-up examinations included magnetic resonance imaging (MRI), neurological assessment, and digital subtraction angiography (6, 12, 26, and 52 weeks). Data registry included age, sex, normal vessel diameter, degree of stenosis, residual stenosis after stent, minimal in-stent diameter, and occurrence of ischemic symptoms during follow-up. RESULTS: Median pre-and postprocedural stenosis rate was 65.4 ± 1{\%} vs 25.1 ± 1{\%}. Technical success rate was 100{\%}. Major procedural complications occurred in 16 patients (8.1{\%}). Combined neurological morbidity and mortality rate at 30 days was 2 patients (0.9{\%}). In 174 stenoses (83{\%}) angiographic follow-up was obtained (mean, 10.2 months). A restenosis (>50{\%}) was observed in 43 (24.7{\%}) cases after 4.2 months (mean) with 4 (9.3{\%}) symptomatic lesions. Incidence of recurrent ischemia related to the stented artery was 2.2{\%} during 10.2 months of mean follow-up. CONCLUSION: Undersized balloon angioplasty and deployment of an Enterprise stent is safe and effective for intracranial stenoses. Follow-up results were equal to or better than those reported for bare-metal balloon-expandable or self-expanding stents and yielded excellent protection from recurrent ischemia.",
keywords = "Atherosclerosis, Endovascular, Enterprise, Intracranial stenosis, Stent",
author = "Z. Vajda and Elisabeth Schmid and Thomas G{\"u}the and Christoph Kl{\"o}tzsch and Alfred Lindner and Ludwig Niehaus and Wolfgang Sperber and Jan Peters and Guy Arnold and Hansj{\"o}rg B{\"a}zner and Hans Henkes",
year = "2012",
month = "1",
doi = "10.1227/NEU.0b013e31822dff0f",
language = "English",
volume = "70",
pages = "91--101",
journal = "Neurosurgery",
issn = "0148-396X",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - The modified bose method for the endovascular treatment of intracranial atherosclerotic arterial stenoses using the enterprise stent

AU - Vajda, Z.

AU - Schmid, Elisabeth

AU - Güthe, Thomas

AU - Klötzsch, Christoph

AU - Lindner, Alfred

AU - Niehaus, Ludwig

AU - Sperber, Wolfgang

AU - Peters, Jan

AU - Arnold, Guy

AU - Bäzner, Hansjörg

AU - Henkes, Hans

PY - 2012/1

Y1 - 2012/1

N2 - BACKGROUND: Balloon dilatation and deployment of a self-expanding stent is a safe treatment for intracranial atherosclerotic stenoses. The significant recurrence rate might be related to the high radial force of the Wingspan stent. OBJECTIVE: To evaluate the procedural safety and stenosis recurrence rate by the use of a stent with reduced radial force (Enterprise). METHODS: Two hundred nine atherosclerotic stenoses (189 patients) were treated (median age, 68 years; 132 male) in a single center. Lesion locations included internal carotid artery (n = 27), middle cerebral artery (n = 62), vertebral artery (n = 64), basilar artery (n = 55), and posterior cerebral artery (n = 1). Pre-and postmedication included acetylsalicylic acid and Clopidogrel for at least 12 months. Preprocedural and follow-up examinations included magnetic resonance imaging (MRI), neurological assessment, and digital subtraction angiography (6, 12, 26, and 52 weeks). Data registry included age, sex, normal vessel diameter, degree of stenosis, residual stenosis after stent, minimal in-stent diameter, and occurrence of ischemic symptoms during follow-up. RESULTS: Median pre-and postprocedural stenosis rate was 65.4 ± 1% vs 25.1 ± 1%. Technical success rate was 100%. Major procedural complications occurred in 16 patients (8.1%). Combined neurological morbidity and mortality rate at 30 days was 2 patients (0.9%). In 174 stenoses (83%) angiographic follow-up was obtained (mean, 10.2 months). A restenosis (>50%) was observed in 43 (24.7%) cases after 4.2 months (mean) with 4 (9.3%) symptomatic lesions. Incidence of recurrent ischemia related to the stented artery was 2.2% during 10.2 months of mean follow-up. CONCLUSION: Undersized balloon angioplasty and deployment of an Enterprise stent is safe and effective for intracranial stenoses. Follow-up results were equal to or better than those reported for bare-metal balloon-expandable or self-expanding stents and yielded excellent protection from recurrent ischemia.

AB - BACKGROUND: Balloon dilatation and deployment of a self-expanding stent is a safe treatment for intracranial atherosclerotic stenoses. The significant recurrence rate might be related to the high radial force of the Wingspan stent. OBJECTIVE: To evaluate the procedural safety and stenosis recurrence rate by the use of a stent with reduced radial force (Enterprise). METHODS: Two hundred nine atherosclerotic stenoses (189 patients) were treated (median age, 68 years; 132 male) in a single center. Lesion locations included internal carotid artery (n = 27), middle cerebral artery (n = 62), vertebral artery (n = 64), basilar artery (n = 55), and posterior cerebral artery (n = 1). Pre-and postmedication included acetylsalicylic acid and Clopidogrel for at least 12 months. Preprocedural and follow-up examinations included magnetic resonance imaging (MRI), neurological assessment, and digital subtraction angiography (6, 12, 26, and 52 weeks). Data registry included age, sex, normal vessel diameter, degree of stenosis, residual stenosis after stent, minimal in-stent diameter, and occurrence of ischemic symptoms during follow-up. RESULTS: Median pre-and postprocedural stenosis rate was 65.4 ± 1% vs 25.1 ± 1%. Technical success rate was 100%. Major procedural complications occurred in 16 patients (8.1%). Combined neurological morbidity and mortality rate at 30 days was 2 patients (0.9%). In 174 stenoses (83%) angiographic follow-up was obtained (mean, 10.2 months). A restenosis (>50%) was observed in 43 (24.7%) cases after 4.2 months (mean) with 4 (9.3%) symptomatic lesions. Incidence of recurrent ischemia related to the stented artery was 2.2% during 10.2 months of mean follow-up. CONCLUSION: Undersized balloon angioplasty and deployment of an Enterprise stent is safe and effective for intracranial stenoses. Follow-up results were equal to or better than those reported for bare-metal balloon-expandable or self-expanding stents and yielded excellent protection from recurrent ischemia.

KW - Atherosclerosis

KW - Endovascular

KW - Enterprise

KW - Intracranial stenosis

KW - Stent

UR - http://www.scopus.com/inward/record.url?scp=84856107788&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84856107788&partnerID=8YFLogxK

U2 - 10.1227/NEU.0b013e31822dff0f

DO - 10.1227/NEU.0b013e31822dff0f

M3 - Article

C2 - 21778921

AN - SCOPUS:84856107788

VL - 70

SP - 91

EP - 101

JO - Neurosurgery

JF - Neurosurgery

SN - 0148-396X

IS - 1

ER -