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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Results after treatment of intracranial artery stenoses using coronary ballon expandable and drug eluting stents

Behandlung zerebraler Gefäßstenosen mit drug-eluting Koronar-Stents

Meeting Abstract

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  • corresponding author Juergen Reul - Kliniken für Neuroradiologie und Neurologie, Siegen und Bonn
  • M. Grond - Kliniken für Neuroradiologie und Neurologie, Siegen und Bonn

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.03.09

The electronic version of this article is the complete one and can be found online at:

Published: April 23, 2004

© 2004 Reul et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




Intracranial artery stenoses are at high risk for cerebral stroke even under anticoagulation. 10% of all ischemic strokes are caused by intracranial stenosis Percutaneous transluminal angioplasty (PTA) of small vessels with and without stenting is an effective treatment in coronary artery disease and is discussed more frequently as an alternative therapy for cerebral artery stenoses. The treatment with stents is difficult, requires special experience and is said to have high complication rates. The restenoses rate using uncoated stents seems to be high. To our knowledge, drug-eluting stents have never been used in human for the primary treatment of intracranial artery stenoses. We therefore report our experience in intracranial stenting in more than 60 patients and additionally present our preliminary results of the first 15 patients with symptomatic intracranial and distal intradural vertebral artery stenoses treated with drug-eluting coronary stents.


76 patients with intracranial stenoses were treated endovascularly (61 treated with bare stents and 15 with drug eluting stents). All patients were symptomatic despite conservative medical treatment. All procedures were done unter general anesthesia. Angioplasty without stenting was done when stent placement was not possible due to anatomical reasons and increased risk. In the acute phase, patients were heparinized, followed by antiaggregation with aspirin an clopidogrel. A sirolimus eluting stent was used in 8 cases, a taxus eluting stent in 7 cases. The size of the stent was defined on the stenosis measurement from 3D rotation angiograms. Follow-up was done clinically and by doppler ultrasound after eight weeks and by control angiography after six month.


A. Bare Stents: Placement with elemination of the stenosis was possible in 55 cases. Angioplasty without stenting was done in 6 cases. Complications were ischemic stroke in 1 case, reversible neurological deficit in 4 cases (resovilng after local fibrinolysis) and artery rupture in 1 Case. Permanent morbidity was 2 %. Mortality was 2% (one of the first patients).

B. Drug-eluting stents: All procedures had been performed without any complication and without a permanent morbidity and mortality. In the control examainations up to now no restenoses were detected.


Angioplasty without stenting includes a higher risk of dissection, vessel rupture and artery occlusion. The treatment of intracranial artery stenoses using balloon expandable stents is a safe and successful method and a (better?) alternative compared to coumadin therapy. We could demonstrate for the first time the feasibility and technical safety of the use of drug-eluting coronary stents for the treatment of symptomatic intracranial artery stenosis. The excellent results with a safe performance during the procedure and the good follow-up results might encourage systematic studies on drug-eluting stents in intracranial recanalization.