Jung Woo Sang, Kim Sam-Soo, Lee Kyung-Yul, Suh Sang Hyun
Department of Radiology, Ajou University School of Medicine, Suwon, Korea.
Department of Radiology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea.
Neurointervention. 2022 Mar;17(1):37-44. doi: 10.5469/neuroint.2022.00017. Epub 2022 Feb 21.
The purpose of this preliminary study is to evaluate the efficacy and safety of the Enterprise stent for intracranial atherosclerotic disease (ICAD) in patients who presented with acute stroke due to vessel steno-occlusion and in patients with symptomatic disease despite optimum medical management.
A retrospective data analysis was performed on 15 consecutive patients who were treated with Enterprise stenting for recanalization of symptomatic intracranial steno-occlusive arteries due to underlying ICAD. Their clinical and radiological data were reviewed to evaluate procedural results, periprocedural and postprocedural complications, and clinical outcome.
Enterprise stents were deployed as a rescue method in 15 patients for recanalization of steno-occlusion. All patients achieved final modified thrombolysis in cerebral infarction (mTICI) score improvement (53.3% with a mTICI score from 0 to 2b or 3, 46.7% with a mTICI score from 1 to 3). Two postprocedural complications (1 symptomatic intracranial hemorrhage and 1 severe brain edema, 13.3%) occurred among 15 patients. Among 12 patients with acute ischemic stroke (AIS), 6 patients (50%) had improvement in their National Institute of Health Stroke Scale of more than 4 at discharge. Seven patients (58.3%) had a good functional outcome with 3-month modified Rankin Score (mRS)≤2, and mortality occurred (mRS=6) in 2 patients (16.7%). None of the 10 AIS and 3 transient ischemic attack patients experienced further ischemic events attributable to the treated steno-occlusion during the follow-up period (ranged from 4 to 36 months, median 12 months).
This retrospective study suggests that Enterprise stenting can effectively and safely achieve recanalization in symptomatic steno-occlusive intracranial arteries.
本初步研究旨在评估Enterprise支架用于因血管狭窄闭塞导致急性卒中的颅内动脉粥样硬化疾病（ICAD）患者以及经最佳药物治疗后仍有症状性疾病患者的疗效和安全性。
对连续15例因潜在ICAD接受Enterprise支架置入术以再通症状性颅内狭窄闭塞动脉的患者进行回顾性数据分析。对他们的临床和影像学数据进行回顾，以评估手术结果、围手术期和术后并发症以及临床结局。
Enterprise支架作为一种挽救方法用于15例患者的狭窄闭塞再通。所有患者最终改良脑梗死溶栓（mTICI）评分均有改善（53.3%的患者mTICI评分从０提高到2b或3，46.7%的患者mTICI评分从1提高到3）。15例患者中发生了2例术后并发症（1例症状性颅内出血和1例严重脑水肿，占13.3%）。在12例急性缺血性卒中（AIS）患者中，6例患者（50%）出院时美国国立卫生研究院卒中量表（NIHSS）改善超过4分。7例患者（58.3%）3个月改良Rankin量表（mRS）评分≤2，功能结局良好，2例患者（16.7%）死亡（mRS=6）。10例AIS患者和3例短暂性脑缺血发作患者在随访期（4至36个月，中位时间12个月）内均未发生与治疗的狭窄闭塞相关的进一步缺血事件。
这项回顾性研究表明，Enterprise支架置入术可有效且安全地实现症状性颅内狭窄闭塞动脉的再通。
