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BioMed Research International
Volume 2013 (2013), Article ID 304320, 10 pages
http://dx.doi.org/10.1155/2013/304320
Review Article

Role of Stenting for Intracranial Atherosclerosis in the Post-SAMMPRIS Era

1Department of Neurosurgery, University of Virginia, Charlottesville, VA 22908, USA
2Neurological Surgery and Radiology, Division of Cerebrovascular and Skull Base Surgery, Department of Neurosurgery, University of Virginia Health System, P.O. Box 800212, Charlottesville, VA 22908, USA

Received 3 October 2013; Accepted 30 October 2013

Academic Editor: Steven J. Monteith

Copyright © 2013 Dale Ding et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. The initial promise of endovascular stenting for the treatment of intracranial atherosclerotic disease (ICAD) has been tempered by the results of the SAMMPRIS trial which demonstrated better outcomes with medical management compared to stenting for symptomatic ICAD. We review post-SAMMPRIS ICAD stenting outcomes. Methods. A comprehensive literature search was performed using PubMed to identify all ICAD stenting series published after the SAMMPRIS in September 2011. The type and design of the stent, number of patients and lesions, inclusion criteria, and clinical and angiographic outcomes were noted. Results. From October 2011 to August 2013, 19 ICAD stenting series were identified describing the interventional outcomes for 2,196 patients with 2,314 lesions. Of the 38 different stents used, 87% were balloon-expandable stents (BESs) and 13% were self-expanding stents. The median minimum stenosis was 50%. The median rates of technical success rate, postprocedural ischemic events, and symptomatic in-stent restenosis (ISR) were 98% (range 87–100%), 9.4% (range 0–25%), and 2.7% (range 0–11.1%), respectively. The median follow-up durations were one to 67 months. Conclusions. The management of severe ICAD remains controversial. Future trials are needed to define the optimal patient, lesion, and stent characteristics which will portend the best outcomes with intervention.