Objective:

To provide an overview of the procedural and clinical outcomes of patients who underwent stenting for symptomatic ICAS.

Background:

Intracranial atherosclerosis (ICAS) is a leading global cause of stroke. The role of intracranial stenting in ICAS remains uncertain. In the SAMMPRIS trial, patients who had experienced recent TIA/CVA secondary to 70-99% ICAS demonstrated an increased risk of recurrent stroke when treated with angioplasty and stenting compared to medical therapy alone. However, the WEAVE trial demonstrated that using the Wingspan stent for ICAS resulted in a low periprocedural complication rate and excellent safety profile. Subsequently, the WOVEN study provided a 1-year follow-up to WEAVE. It presented a more homogeneous patient group than in prior studies, and demonstrated a relatively low 8.5% 1-year rate of stroke and death in stented patients.

Design/Methods:

We reviewed a database of interventional procedures to identify patients who underwent intracranial stenting for symptomatic ICAS. The outcomes of interest included successful stent placement, restoration of blood flow, procedural complications, symptomatic improvement, change in NIHSS, and mortality and stroke within one year.

Results:

Thirty-five patients underwent intracranial stenting for symptomatic ICAS. All had successful stent placement and restoration of blood flow. Six (17.1%) experienced perioperative complications including stent occlusion, bradycardia, and hematoma. Regarding clinical outcomes, twenty-five (71.4%) showed improvement in their TIA/CVA symptoms, including dizziness, weakness, and speech difficulties. Twenty-one (60%) had improved NIHSS scores by discharge, nine (25.7%) remained stable, and four (11.4%) deteriorated. One unrelated mortality was recorded at 1-year post-procedure.

Conclusions:

This case series demonstrates the successful and effective restoration of distal blood flow through intracranial stenting for symptomatic ICAS. The low rates of perioperative complications and potential improvements in patients' clinical outcomes suggest the need for further investigation into the patient selection, safety, and effectiveness of intracranial stenting for managing symptomatic ICAS.