Effect of a Drug-Eluting Stent vs. Bare Metal Stent for the Treatment of Symptomatic Intracranial and Vertebral Artery Stenosis.

Background: For patients with symptomatic intracranial and vertebral artery stenosis who receive endovascular treatment, in-stent restenosis (ISR) is associated with the recurrence of ischemic stroke. This study evaluated a drug-eluting stent (DES) vs. bare metal stent (BMS) for the treatment of symptomatic intracranial and vertebral artery stenosis.

Endovascular thrombectomy versus standard bridging thrombolytic with endovascular thrombectomy within 4·5 h of stroke onset: an open-label, blinded-endpoint, randomised non-inferiority trial.

Background: The benefit of combined treatment with intravenous thrombolysis before endovascular thrombectomy in patients with acute ischaemic stroke caused by large vessel occlusion remains unclear. We hypothesised that the clinical outcomes of patients with stroke with large vessel occlusion treated with direct endovascular thrombectomy within 4·5 h would be non-inferior compared with the outcomes of those treated with standard bridging therapy (intravenous thrombolysis before endovascular thrombectomy).

Methods: DIRECT-SAFE was an international, multicentre, prospective, randomised, open-label, blinded-endpoint trial.

Corrigendum: Long-Term Risk Factors for Intracranial In-Stent Restenosis From a Multicenter Trial of Stenting for Symptomatic Intracranial Artery Stenosis Registry in China.

[This corrects the article DOI: 10.3389/fneur.2020.

Long-Term Risk Factors for Intracranial In-Stent Restenosis From a Multicenter Trial of Stenting for Symptomatic Intracranial Artery Stenosis Registry in China.

For patients with symptomatic intracranial artery stenosis (sICAS), endovascular treatment has been shown to be feasible and safe in recent studies. However, in-stent restenosis (ISR) risks the recurrence of ischemic stroke. We attempt to elucidate the risk factors for ISR.

Outcome of endovascular recanalization for intracranial in-stent restenosis.

Background And Purpose: In-stent restenosis (ISR) is one of the long-term adverse outcomes of endovascular angioplasty and stenting for symptomatic intracranial arterial stenosis. In this study, we try to evaluate the safety and efficacy of endovascular treatment for intracranial ISR.

Methods: We retrospectively collected patients with intracranial ISR who underwent endovascular treatment from June 2012 to August 2019 at a high-volume stroke center.

Early versus delayed stenting for intracranial atherosclerotic artery stenosis with ischemic stroke.

Objective: To evaluate the clinical outcomes of early stenting (≤14 days) or late stenting (>14 days) in patients who underwent intracranial stent placement.

Methods: Patients with ischemic stroke caused by 70-99% intracranial atherosclerotic stenosis combined with poor collaterals were enrolled. The early stenting group, who underwent stenting within 14 days of last ischemic symptoms, were compared with the late stenting group who underwent stenting >14 days from last ischemic symptom.

A rare case report of a mixed persistent proatlantal intersegmental artery.

Adults with persistent proatlantal intersegmental artery (PPIA) are rarely seen. We present a case of a special type of PPIA that was in a 57-year-old man who presented with dizziness and episodic vertigo of 9 months duration. The diagnosis relied on computed tomography angiography and digital subtraction angiography, by which a left internal carotid artery stenosis and an ipsilateral PPIA originating from the external carotid artery (ECA) was found.

Visual field impairment predicts recurrent stroke after acute posterior circulation stroke and transient ischemic attack.

Aims: To evaluate whether visual field impairment (VFI) can predict stroke recurrence in patients with vertebral-basilar (VB) stroke.

Methods: A total of 326 patients were eligible for a VFI evaluation within 1 week of stroke onset. One-year follow-up data were obtained after VB stroke and other vascular events.

Mechanical thrombectomy and rescue therapy for intracranial large artery occlusion with underlying atherosclerosis.

Objective: To investigate the safety and efficacy of mechanical thrombectomy plus rescue therapy for intracranial large artery occlusion (ILAO) with underlying intracranial atherosclerosis (ICAS).

Methods: Patients enrolled in the intervention group of EAST (Endovascular Therapy for Acute ischemic Stroke Trial) were analyzed. For underlying ICAS identified during the stent retrieval procedure, rescue treatment was required for those with (1) a degree of arterial stenosis >70% or (2) any degree of arterial with blood flow impairment or (3) evidence of re-occlusion.

Association of genetic variant and platelet function in patients undergoing neuroendovascular stenting.

Introduction: The risk of recurrent ischaemic events is related to platelet function, which is often assessed by thromboelastography (TEG). TEG has high interindividual variability.

Objective: To identify causal variants associated with TEG parameters in patients who receive aspirin and clopidogrel after intra- or extracranial stenting.

The impact of P2Y12 promoter DNA methylation on the recurrence of ischemic events in Chinese patients with ischemic cerebrovascular disease.

The primary mechanism of clopidogrel resistance is still unclear. We aimed to investigate whether the methylation status of the P2Y12 promoter has effects on platelet function and clinical ischemic events. Patients with ischemic cerebrovascular disease were enrolled into our study.

Fractional Flow Assessment for the Evaluation of Intracranial Atherosclerosis: A Feasibility Study.

Purpose: Current studies on endovascular intervention for intracranial atherosclerosis select patients based on luminal stenosis. Coronary studies demonstrated that fractional flow measurements assess ischemia better than anatomical stenosis and can guide patient selection for intervention. We similarly postulated that fractional flow can be used to assess ischemic stroke risk.

Association of PON1, P2Y12 and COX1 with Recurrent Ischemic Events in Patients with Extracranial or Intracranial Stenting.

Background And Purpose: Short-term combined use of clopidogrel and aspirin improves cerebrovascular outcomes in patients with symptomatic extracranial or intracranial stenosis. Antiplatelet non-responsiveness is related to recurrent ischemic events, but the culprit genetic variants responsible for the non-responsiveness have not been well studied. We aimed to identify the genetic variants associated with poor clinical outcomes.

Combined use of stent angioplasty and mechanical thrombectomy for acute tandem internal carotid and middle cerebral artery occlusion.

Purpose: Tandem internal carotid and middle cerebral artery occlusion carries a grave prognosis, with intravenous and intra-arterial thrombolytics having low efficacy. Currently, endovascular therapy is a promising means for treatment in which the proximal carotid lesion can be treated with angioplasty and stenting, whilst mechanical thrombectomy can be used for the treatment of the distal occlusion. Two approaches can be used - the antegrade (proximal-to-distal) approach or the retrograde (distal-to-proximal) approach, although there has not yet been any consensus on which is the better approach.

Association of thrombelastographic parameters with post-stenting ischemic events.

Background And Purpose: Thrombelastography (TEG) is widely used for the measurement of platelet function. However, few studies have investigated the TEG parameters in patients receiving extracranial or intracranial artery stenting for ischemic cerebrovascular disease. This study sought to describe the association of TEG parameters before the procedure with post-procedural ischemic events after extracranial or intracranial artery stenting.

Selective use of transradial access for endovascular treatment of severe intracranial vertebrobasilar artery stenosis.

Objective: To study the feasibility and safety of transradial artery access for endovascular intervention of severe intracranial vertebrobasilar stenosis for selected patients not suitable for transfemoral access.

Methods: This was a retrospective analysis of 58 patients who had undergone intervention for severe intracranial vertebrobasilar stenosis using transradial access between January 2012 and September 2014. The reasons for transradial access were traced.

Thirty-day outcome of carotid artery stenting in Chinese patients: a single-center experience.

Background: Carotid artery stenting (CAS) as a competing treatment modality has had to adhere to limits to gain widespread acceptance in some studies. This study analyzed the clinical data of 1700 consecutive patients after CAS to retrospectively evaluate the 30-day outcome of CAS for internal carotid artery stenosis in a Chinese population.

Methods: Medical records of 1700 patients who underwent CAS at Xuanwu Hospital affiliated to Capital Medical University between January 2001 and August 2012 were reviewed.

Entrapment of a micro-guidewire during stenting of basilar stenosis.

Entrapment of a microwire related to intracranial endovascular therapy is an uncommon complication. A 64-year-old man with symptomatic basilar artery stenosis was treated with stenting. A 300 cm Synchro microwire became trapped in the P1 segment of the left posterior cerebral artery during the procedure.

Entrapment of a micro-guidewire during stenting of basilar stenosis.

Entrapment of a microwire related to intracranial endovascular therapy is an uncommon complication. A 64-year-old man with symptomatic basilar artery stenosis was treated with stenting. A 300 cm Synchro microwire became trapped in the P1 segment of the left posterior cerebral artery during the procedure.

Endovascular recanalization for chronic symptomatic middle cerebral artery total occlusion.

The optimal treatment of chronic middle cerebral artery (MCA) occlusion is unclear. Angioplasty and stenting may be an alternative treatment for patients with recurrent ischemic symptoms despite medical therapy. Two patients with chronic right MCA occlusion successfully treated with stenting are reported, together with their long term follow-up to illustrate the feasibility of endovascular recanalization.

Color Doppler imaging evaluation of proximal vertebral artery stenosis.

Objective: The sonographic diagnostic criteria for vertebral artery stenosis have not been fully investigated. The purpose of this study was to assess hemodynamic parameters at color Doppler imaging and to determine, with digital subtraction angiography as the reference standard, the optimal thresholds for evaluation of proximal vertebral artery stenosis.

Materials And Methods: Among 653 patients with symptoms of ischemia of the posterior circulation, 247 subjects with normal arteries or stenosis of the proximal vertebral artery confirmed with digital subtraction angiography were included in the study.

Treatment of symptomatic complex posterior circulation cerebral artery stenosis with balloon-mounted stents: technique feasibility and outcome.

Purpose: This study aimed to retrospectively analyze a series of patients with complex posterior circulation stenosis who underwent stent-assisted angioplasty to evaluate the feasibility of the procedure and summarize the experience with regard to complications.

Methods: A total of 16 consecutive patients with 27 complex posterior circulation artery stenoses refractory to medical therapy were enrolled. Technical success rate, periprocedural complication, and long-term follow-up result were evaluated.

[Evaluation by perfusion-weighted magnetic resonance to hemodynamic character and surgical effect of carotid system stenoses or occlusion].

Objective: To evaluate hemodynamic character and surgical effect of stenoses or occlusion of carotid artery system by perfusion-weighted MRI.

Methods: Twenty-one patients with stenoses or occlusion of carotid artery system underwent surgical treatment. Two patients underwent endarterectomy, extracranial-intracranial arterial bypass to 10 patients, and percutaneous stent angioplasty to 9 patients.

[Percutaneous transluminal stenting for stenosis of internal carotid artery: a report of 355 cases].

Objective: To discuss the benefits and complications of percutaneous transluminal stenting for stenosis of internal carotid artery (ICA).

Methods: 355 patients with ICA stenosis were included from 1997 to 2003. All of them took periprocedual anticoagulation treatment, cerebral vascular angiography and cervical Doppler sonography.