Midterm Clinical and Angiographic Follow-Up for the First Food and Drug Administration-Approved Prospective, Single-Arm Trial of Primary Stenting for Stroke: SARIS (Stent-Assisted Recanalization for Acute Ischemic Stroke)

Author:

Levy Elad I123,Rahman Maryam4,Khalessi Alexander A1,Beyer Patrick T1,Natarajan Sabareesh K1,Hartney Mary L1,Fiorella David J5,Hopkins L Nelson123,Siddiqui Adnan H123,Mocco J4

Affiliation:

1. Departments of Neurosurgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York

2. Departments of Radiology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York

3. Departments of Toshiba Stroke Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York

4. Department of Neurosurgery, University of Florida, Gainesville, Florida

5. Department of Neurological Surgery, Stony Brook University Medical Center, Stony Brook, New York

Abstract

Abstract BACKGROUND: Although early data demonstrate encouraging angiographic results following intracranial stent deployment for acute ischemic stroke, longer-term follow-up is necessary to evaluate the clinical outcomes, as well as the durability of angiographic results. OBJECTIVE: We report 6-month clinical and radiologic follow-up data of the 20 patients prospectively enrolled in the Stent-Assisted Recanalization in acute Ischemic Stroke (SARIS) trial. METHODS: Twenty patients were prospectively enrolled to receive self-expanding intra-arterial stents as first-line therapy for acute ischemic stroke treatment. Patients were scheduled for follow-up 6-months after treatment for clinical evaluation (modified Rankin Scale [mRS] score obtained by a trained certified research nurse/nurse practitioner) and repeat cerebral angiography. Angiographic interpretation was performed by an independent adjudicator. RESULTS: At 6 months, the mRS score was ≤3 in 60% of patients (n = 12) and was ≤2 in 55% of patients (n = 11). Mortality at the 6-month follow-up was 35% (n = 7). Follow-up angiography was performed for 85% (11 of 13) of surviving patients. All patients undergoing angiographic follow-up demonstrated Thrombolysis in Myocardial Infarction 3 flow on digital subtraction angiography or stent patency on computed tomographic angiography. None of the patients demonstrated evidence of in-stent stenosis (≥50% vessel narrowing). CONCLUSION: The midterm angiographic and clinical results following intracranial stent deployment for acute ischemic stroke are encouraging. Further study of primary stent-for-stroke treatment is warranted.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Clinical Neurology,Surgery

Reference37 articles.

1. Stent placement in acute cerebral artery occlusion: use of a self-expandable intracranial stent for acute stroke treatment;Brekenfeld;Stroke,2009

2. Self-expanding stents for recanalization of acute cerebrovascular occlusions;Levy;AJNR Am J Neuroradiol,2007

3. Interventional acute ischemic stroke therapy with intracranial self-expanding stent;Zaidat;Stroke,2008

4. First Food and Drug Administration-approved prospective trial of primary intracranial stenting for acute stroke: SARIS (stent-assisted recanalization in acute ischemic stroke);Levy;Stroke,2009

5. Thrombolysis in acute ischemic stroke: controlled trials and clinical experience;Hacke;Neurology,1999

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