A New Fibrin-Heparine Coated Self-Expanding Stent for the Rescue Treatment of Intracranial Stenosis—a Multicentric Study
-
Published:2024-08-23
Issue:
Volume:
Page:
-
ISSN:1869-1439
-
Container-title:Clinical Neuroradiology
-
language:en
-
Short-container-title:Clin Neuroradiol
Author:
Dorn FranziskaORCID, Voss Yves Leonard, Zidan Mousa, Neuhaus Stephanie, Lehnen Nils, Stracke Paul, Schwindt Wolfram, Ergawy Mostafa, Dyzmann Christian, Moehlenbruch Markus, Jesser Jessica, Vollherbst Dominik, Moreu Manuel, Pérez-García Carlos, Bester Maxim, Flottmann Fabian, Simgen Andreas, Schob Stefan, Berlis Ansgar, Maurer Christoph, Buhk Jan Hendrik, Hentschel Hannah, Loehr Christian, Eckert Bernd, Saura Javier, Delgado Fernando, Paech Daniel, Nordmeyer Hannes
Abstract
Abstract
Introduction
Rescue intracranial stenting is necessary to provide sufficient recanalization after mechanical thrombectomy (MT) in patients with acute large vessel occlusions (LVO) due to an underlying intracranial atherosclerotic disease (ICAD). The CREDO heal is a novel stent that provides a potentially lower thrombogenicity due to surface modification. We present the first multicentric experience with the CREDO heal for acute rescue stenting.
Methods
Data of 81 patients who underwent rescue stenting after MT at 12 centers in Germany and Spain were prospectively collected and retrospectively evaluated.
Results
Final mTICI 2b‑3 was reached in 95.1% after median two MT maneuvers and stenting. Four periprocedural complications resulted in clinical deterioration (4.9%). Intraparenchymal hemorrhage occurred in one patient (1.2%) and functional independence at FU was reached by 42% of the patients. Most interventions were performed under Gp IIb/IIIa inhibitors.
Conclusion
CREDO heal was effective and safe in our case series. However, more data is needed to define the optimal antithrombotic regime. The use under single antiplatelet medication is not supported by our study.
Funder
Universitätsklinikum Bonn
Publisher
Springer Science and Business Media LLC
Reference30 articles.
1. Goyal M, Menon BK, van Zwam WH, Dippel DW, Mitchell PJ, Demchuk AM, Dávalos A, Majoie CB, van der Lugt A, de Miquel MA, Donnan GA, Roos YB, Bonafe A, Jahan R, Diener HC, van den Berg LA, Levy EI, Berkhemer OA, Pereira VM, Rempel J, Millán M, Davis SM, Roy D, Thornton J, Román LS, Ribó M, Beumer D, Stouch B, Brown S, Campbell BC, van Oostenbrugge RJ, Saver JL, Hill MD, Jovin TG. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet. 2016;387(10029):1723–31. https://doi.org/10.1016/S0140-6736(16)00163-X. 2. Yoo AJ, Andersson T. Thrombectomy in acute ischemic stroke: challenges to procedural success. J Stroke. 2017;19(2):121–30. https://doi.org/10.5853/jos.2017.00752. 3. Liebeskind DS, Bracard S, Guillemin F, Jahan R, Jovin TG, Majoie CB, Mitchell PJ, van der Lugt A, Menon BK, San Román L, Campbell BC, Muir KW, Hill MD, Dippel DW, Saver JL, Demchuk AM, Dávalos A, White P, Brown S, Goyal M, Collaborators HERMES. eTICI reperfusion: defining success in endovascular stroke therapy. J Neurointerv Surg. 2019;11(5):433–8. https://doi.org/10.1136/neurintsurg-2018-014127. 4. Tao C, Nogueira RG, Zhu Y, Sun J, Han H, Yuan G, Wen C, Zhou P, Chen W, Zeng G, Li Y, Ma Z, Yu C, Su J, Zhou Z, Chen Z, Liao G, Sun Y, Ren Y, Zhang H, Chen J, Yue X, Xiao G, Wang L, Liu R, Liu W, Liu Y, Wang L, Zhang C, Liu T, Song J, Li R, Xu P, Yin Y, Wang G, Baxter B, Qureshi AI, Liu X, Hu W, ATTENTION Investigators. Trial of endovascular treatment of acute basilar-artery occlusion. N Engl J Med. 2022;387(15):1361–72. https://doi.org/10.1056/NEJMoa2206317. 5. Sacco RL, Kargman DE, Gu Q, Zamanillo MC. Race-ethnicity and determinants of intracranial atherosclerotic cerebral infarction. The Northern Manhattan stroke study. Stroke. 1995;26(1):14–20. https://doi.org/10.1161/01.str.26.1.14.
|
|