Biomaterial Database

Intracranial stenting of atherosclerotic stenoses: current status and perspectives. 2009

Joachim Berkefeld, and Friedhelm E Zanella

Department of Neuroradiology, Johann Wolfgang Goethe University, Frankfurt/Main, Germany. Berkefeld@em.uni-frankfurt.de

The purpose of this review article is to give an overview of the current development of intracranial stenting for treatment of atherosclerotic stenoses. Natural history and methods for diagnostic imaging are described as basis for the indication for endovascular treatment. Target group are patients with high-grade symptomatic stenoses > 70%. Technical standards for the use of self-expanding and balloon-expandable stents are reported together with the results of clinical case series. It seems to be difficult to drop acute complication rates (procedure-related stroke and death during the first 30 days) reliably from current levels of around 10% to values < 6%, which are more acceptable for a prophylactic procedure for the prevention of stroke. High restenosis rates up to 30% in the 1st year raised concerns about long-term efficacy. Further technical developments and improved criteria for patient selection are necessary to make intracranial stenting safer and more effective before a randomized trial (stent vs. medical treatment) may prove superiority of the endovascular approach.

UI	MeSH Term	Description	Entries
D001807	Blood Vessel Prosthesis	Device constructed of either synthetic or biological material that is used for the repair of injured or diseased blood vessels.	Vascular Prosthesis,Blood Vessel Prostheses,Tissue-Engineered Vascular Graft,Graft, Tissue-Engineered Vascular,Grafts, Tissue-Engineered Vascular,Prostheses, Blood Vessel,Prostheses, Vascular,Prosthesis, Blood Vessel,Prosthesis, Vascular,Tissue Engineered Vascular Graft,Tissue-Engineered Vascular Grafts,Vascular Graft, Tissue-Engineered,Vascular Grafts, Tissue-Engineered,Vascular Prostheses,Vessel Prostheses, Blood,Vessel Prosthesis, Blood
D002537	Intracranial Arteriosclerosis	Vascular diseases characterized by thickening and hardening of the walls of ARTERIES inside the SKULL. There are three subtypes: (1) atherosclerosis with fatty deposits in the ARTERIAL INTIMA; (2) Monckeberg's sclerosis with calcium deposits in the media and (3) arteriolosclerosis involving the small caliber arteries. Clinical signs include HEADACHE; CONFUSION; transient blindness (AMAUROSIS FUGAX); speech impairment; and HEMIPARESIS.	Cerebral Arteriosclerosis,Intracranial Atherosclerosis,Cerebral Atherosclerosis,Arterioscleroses, Cerebral,Arterioscleroses, Intracranial,Arteriosclerosis, Cerebral,Arteriosclerosis, Intracranial,Atheroscleroses, Cerebral,Atheroscleroses, Intracranial,Atherosclerosis, Cerebral,Atherosclerosis, Intracranial,Cerebral Arterioscleroses,Cerebral Atheroscleroses,Intracranial Arterioscleroses,Intracranial Atheroscleroses
D002548	Cerebral Revascularization	Microsurgical revascularization to improve intracranial circulation. It usually involves joining the extracranial circulation to the intracranial circulation but may include extracranial revascularization (e.g., subclavian-vertebral artery bypass, subclavian-external carotid artery bypass). It is performed by joining two arteries (direct anastomosis or use of graft) or by free autologous transplantation of highly vascularized tissue to the surface of the brain.	Brain Revascularization,EC-IC Arterial Bypass,Extracranial-Intracranial Arterial Bypass,Microsurgical Revascularization, Cerebral,STA-MCA Bypass,Cerebral Microsurgical Revascularization,Arterial Bypass, EC-IC,Arterial Bypass, Extracranial-Intracranial,Arterial Bypasses, EC-IC,Arterial Bypasses, Extracranial-Intracranial,Bypass, EC-IC Arterial,Bypass, Extracranial-Intracranial Arterial,Bypass, STA-MCA,Bypasses, EC-IC Arterial,Bypasses, Extracranial-Intracranial Arterial,Bypasses, STA-MCA,Cerebral Microsurgical Revascularizations,EC IC Arterial Bypass,EC-IC Arterial Bypasses,Extracranial Intracranial Arterial Bypass,Extracranial-Intracranial Arterial Bypasses,Revascularization, Brain,Revascularization, Cerebral,Revascularization, Cerebral Microsurgical,STA MCA Bypass,STA-MCA Bypasses
D005544	Forecasting	The prediction or projection of the nature of future problems or existing conditions based upon the extrapolation or interpretation of existing scientific data or by the application of scientific methodology.	Futurology,Projections and Predictions,Future,Predictions and Projections
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015607	Stents	Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.	Stent