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Journal of Peking University(Health Sciences) ›› 2019, Vol. 51 ›› Issue (5): 835-839. doi: 10.19723/j.issn.1671-167X.2019.05.008

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Application of Neuroform EZ stent in the treatment of severe intracranial arterial stenosis with complex symptomatic

Zi-chang JIA1,Huan-ju BIAN2,Xuan LI1,Jing-yuan LUAN1,Chang-ming WANG1,Qi-jia LIU1,Jin-tao HAN1,△()   

  1. 1. Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing 100191, ChinaDepartment of Neurology, Peking University Third Hospital, Beijing 100191, China
    2. Department of Neurology, Guanxian People’s Hospital, Liaocheng 252500, Shandong, China
  • Received:2018-08-29 Online:2019-10-18 Published:2019-10-23
  • Contact: Jin-tao HAN E-mail:bmucystal@163.com

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Abstract:

Objective: To assess the safety and efficacy of Neuroform EZ stent used in treatment of symptomatic complex severe intracranial atherosclerotic stenosis (ICAS). Methods: Clinical data of 18 patients with symptomatic complex severe ICAS undergoing Neuroform EZ stent angioplasty from January 2016 to December 2017 were retrospectively analyzed. All the lesions of the patients in this group were considered as complex ICAS, i.e. with severe tortuous access, long (>10 mm) or occlusive or bifurcation lesions, with concurrent aneurysms near the stenotic lesion. The primary outcome was defined as any stroke (including ischemic or hemorrhagic) or deaths from any cause after stenting procedure within 30 days. The secondary outcome was defined as successful revascularization and occurrence of >50% in-stent restenosis during the follow-up period. Results: All the 18 patients achieved technical success (100%) and mean stenosis rate was reduced from 85%±7% to 18%±6%. Of the 18 patients inclu-ded, the 30-day stroke or death was 5.6% (1/18), which presented as basal ganglia region infarction in a patient with tandem lesions on the left vertebral artery. There was no hemorrhagic and death complications that occurred in the patients of this group. One concurrent aneurysm was embolized with micro coil (stent assisted) by stages after 1 month. In this group 12 patients were followed up with digital subtraction angiography (DSA) after hospital discharge. The follow-up period ranged from 8 months to 26 months [mean: (16±8) months].During the follow-up period 2 patients in the 12 patients (2/12, 16.7%) developed in-stent restenosis (ISR) confirmed by DSA, and one of them was symptomatic res-tenosis and restored unobstructed blood flow after balloon angioplasty. Conclusion: Neuroform EZ stent for the treatment of highly screened symptomatic complex severe ICAS is safe and effective. It has its advantages over traditional stent.

Key words: Intracranial arteriosclerosis, Stroke, Stents

CLC Number: 

  • R743.3

Figure 1

DSA image showed long segment total occlusion of V4 part of left vertebral artery pre-operation"

Figure 2

DSA image showed the returned forward flow of V4 part of left vertebral artery after stenting with Neuroform EZ stent"

Table 1

Operation consumables and clinical outcomes (n=18)"

Items Data
Balloon diameter, n(%)
1.5 mm/2.0 mm 11 (61.1)
2.5 mm/3.0 mm 7 (38.9)
Stent diameter, n(%)
2.5 mm 3 (16.7)
3.0 mm 5 (27.7)
3.5 mm 3 (16.7)
4.0 mm 3(16.7)
4.5 mm 4 (22.2)
Stent length, n(%)
15 mm 4 (22.2)
20 mm 8 (44.5)
30 mm 6 (33.3)
Mean rate of stenosis, x?±s
Pre-operation 85%±7%
Post-operation 18%±6%
Primary outcomes (within 30 d), n(%)
Ischemic stroke 1 (5.6)
Hemorrhagic stroke 0
Death from any cause 0
Secondary outcomes, n(%)
Successful revascularization 18 (100.0)
In-stent restenosis during follow-up period* 2 (16.7)
TIA during follow-up period* 1 (8.3)
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