Go Back   SuggestADoctor.com > Kennith Franklin LAYTON MD
 


Recurrent Intracranial Stenosis Induced by the Wingspan Stent: Comparison with Balloon Angioplasty alone in a Single Patient.

Kennith Franklin LAYTON
Kennith Franklin LAYTON MD
Texas, Dallas
Radiology
Registered Site MemberAddress AvailablePhone Numbers AvailableHas 22 ArticlesPersonal Photo AvailableHas special expertise in certain sicknessHas TagsPersonal Info AvailableHas Personal Website
Article Details
* Date : 06-08-2009 - 07:12 PM (5407 days ago),

* Characters : 2846, Words : 413, Size : 2.78 Kb.
Recurrent Intracranial Stenosis Induced by the Wingspan Stent: Comparison with Balloon Angioplasty alone in a Single Patient.

SUMMARY: We present a case in which angioplasty alone and stent-assisted angioplasty were performed in the same patient to treat medically refractory intracranial stenoses. This elderly patient with presumed intracranial atherosclerotic disease underwent angioplasty alone for his anterior cerebral artery stenosis. Stent-assisted angioplasty was used for treatment of his ipsilateral middle cerebral artery stenosis. Follow-up angiography at 4 months documented severe recurrent stenosis confined only to the stented portion of the middle cerebral artery.

We present this case because the patient's anatomy offers a fortuitous chance to compare, in a single subject, the results of angioplasty alone with the results of stent-assisted angioplasty. Both the M1 and A1 segments initially presented with high-grade stenoses. However, we noted marked neointimal hyperplasia in the stent-bearing M1 segment compared with nearly absent neointimal hyperplasia in the nonstent-bearing A1 segment. This finding implies that the stent itself may elicit neointimal hyperplasia beyond that produced by angioplasty alone. In light of the recent upsurge in enthusiasm for stent placement for ICAD, this case gives us pause concerning what we actually know about the fundamental biology of intracranial vessels in response to stent placement.

There are currently no data from a controlled study comparing angioplasty alone with stent-assisted angioplasty in a large cohort of patients. However, there have been recent reports suggesting high rates of restenosis in stent-assisted angioplasty cases.4-6 Subgroup analysis of the same cohort implicated stenoses in young patients in the supraclinoid ICA as those most prone to restenosis.6 Given that particular subgroups display a higher propensity to restenosis, it seems that not all stenotic intracranial lesions are alike in their response to stent implantation. Our single case offers some potential advantage over these previous reports, because the nonstented A1 segment acted as an internal control for the stented M1 segment. Of significant note, the patient reported herein was not young, and his restenotic lesion was not in the supraclinoid ICA. This suggests to us that the stent itself may be the primary factor in the development of restenosis. Indeed, a previous series of intracranial angioplasty alone has reported restenosis rates apparently lower than that seen with stent placement.3

We readily admit that a single case report can prove nothing definitively. It is true that restenosis is a documented event after angioplasty alone in ICAD. This case and the recent reports of stent-associated restenosis illustrate the critical need for a randomized trial comparing angioplasty alone with stent-assisted angioplasty in patients with ICAD who have failed maximum medical therapy.7

Return to Doctor's Page
Email This Doctor

To Quote this article, you should add: :

All rights of Article "Recurrent Intracranial Stenosis Induced by the Wingspan Stent: Comparison with Balloon Angioplasty alone in a Single Patient." belongs to Kennith Franklin LAYTON MD and it is published at SuggestADoctor.com (http://www.suggestadoctor.com) Health Articles Library.

With this notice, you can quote reasonable amount of text from this article but you have to get permission from its author to republish or redistribute it fully.

Other Articles by Kennith Franklin LAYTON MD:
  • Use Of Covered Stent Grafts İn The Extracranial Carotid Artery: Report Of Three Patients With Follow-Up Between 8 And 42 Months.
  • Percutaneous Sacroplasty Using Ct Fluoroscopy.
  • A Modified Vertebroplasty Approach For Spine Biopsies.
  • Expanding The Treatment Window With Mechanical Thrombectomy İn Acute Ischemic Stroke.
  • Transarterial Coil Embolization Of The Venous Component Of Aggressive Type 4 Dural Arteriovenous Fistulas.
  • The Radial Artery Access Site For Interventional Neuroradiology Procedures.
  • Bovine Aortic Arch Variant İn Humans: Clarification Of A Common Misnomer.
  • Subsequent Vertebral Fractures After Vertebroplasty: Association With Intraosseous Clefts.
  • Acute Vertebral Compression Fractures İn Patients With Multiple Myeloma: Evaluation Of Vertebral Body Edema Patterns On Mr Imaging And The Implications For Vertebroplasty.
  • Vertebral Endplate Fractures: An Indicator Of The Abnormal Forces Generated İn The Spine After Vertebroplasty.
  • Use Of The Ulnar Artery As An Alternative Access Site For Cerebral Angiography.
  • Angioplasty Of An Idiopathic Intracranial Arterial Stenosis.
  • Balloon-Assisted Coiling Through A 5-French System.
  • Outcomes Of Patients Receiving Long-Term Corticosteroid Therapy Who Undergo Percutaneous Vertebroplasty.
  • Specificity Of Mr Angiography As A Confirmatory Test For Carotid Artery Stenosis: İs İt Valid?
  • Vertebroplasty, First 1000 Levels Of A Single Center: Evaluation Of The Outcomes And Complications.
  • Endovascular Treatment Of Epistaxis İn Patients With Hereditary Hemorrhagic Telangiectasia.
  • Balloon-Assisted Coiling Of Intracranial Aneurysms: Evaluation Of Local Thrombus Formation And Symptomatic Thromboembolic Complications.
  • Transorbital Puncture For The Treatment Of Cavernous Sinus Dural Arteriovenous Fistulas.
  • Isolated Third Nerve Palsy Assocaited With A Ruptured Anterior Communicating Artery Aneurysm.
  • Some other Health Articles from our Library:
  • Facial Plastic Surgery Earns İts Place On ‘most Popular’ Holiday Gift List , Rich CASTELLANO MD
  • Brotox A Phenomenon Popular İn Tampa Bay , Rich CASTELLANO MD
  • Proof Positive, Facial Lifting Procedures Work , Rich CASTELLANO MD
  • Liposuction Is A Treatment For Obesity , Thomas LOCKE MD
  • Weight Loss After Pregnancy , Michele CAVENEE MD
  • Lymphedema — An Overview , Margarita CORREA MD
  • Identification Of A Novel Compound Heterozygous Mutation Of The 5 Alpha-Reductase Type 2 (Srd5a2) Gene İn An Extreme Premature 46, Xy Male İnfant , Cayce JEHAIMI MD
  • "Positron Emission Tomography İn The Management Of Papillary Thyroid Carcinoma İn Children: İs There A Role?" , Cayce JEHAIMI MD
  • "Primary Pigmented Nodular Adrenocortical Disease İn A Patient With Carney Complex: A Case Report" , Cayce JEHAIMI MD
  • "Novel Intervening Sequence Mutation At The 5 , Cayce JEHAIMI MD
  • "Polycystic Ovaries And Adrenal Insufficiency İn A Young Pubescent Female With Lipoid Congenital Adrenal Hyperplasia Due To Splice Mutation Of The Star Gene: A Case Report & Review Of The Literature" , Cayce JEHAIMI MD
  • "Sexual Precocity İn A 2-Year-Old Boy Caused By Indirect Exposure To Testosterone Cream" , Cayce JEHAIMI MD
  • Chemical Addictions , Minh Anh HAN MD
  • Muscle Knot? It Might Be A Trigger Point , Minh Anh HAN MD
  • Cancer Rehabilitation Experience Over Twelve Years. Abstract- Amsterdam, Netherlands 2009 , Susan E CARTER MD
  • Cancer And Exercise. Abstract Brisbane, Australia 2009 , Susan E CARTER MD
  • Is Bacteria Causing You To Feel Bloated Or Have Excessive Flatulence? , Rakesh GUPTA MD
  • Stress And Irritable Bowel Syndrome İn The Real World , Rakesh GUPTA MD
  • Roger Rabbit Medical Mishaps , Mark SARACINO MD
  • Dangerous Herb And Drug Combinations , Mark SARACINO MD
  • All articles published in SuggestADoctor.com is written by Medical Doctors who are also our site members. So although they are considered as depandable resources they should never be used by site visitors without consulting with their own medical doctors, nor should be taken for granted about their being updated or accurate.These articles are for information purposes only and every information they contain must be checked with your own Medical professional.