{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T09:00:19Z","timestamp":1780736419130,"version":"3.54.1"},"reference-count":80,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2009,3]]},"abstract":"\n Object<\/jats:title>\n The authors reviewed their experience in 7 cases of nonacute intracranial occlusions and near occlusions in which the patients underwent intracranial angioplasty and stent implantation for direct cerebral revascularization.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Between 2005 and 2008, 4 men and 3 women underwent direct cerebral revascularization of nonacute intracerebral occlusions or near occlusions. Five patients had chronic angiographically documented occlusion and 2 patients had chronic angiographically documented near occlusions. The locations of the treated vessels included 2 supraclinoid internal carotid arteries, 4 middle cerebral arteries, and 1 vertebral artery. Prior to intervention, all patients were symptomatic and experienced strokes ipsilateral to their occlusions. In addition, all patients had clinical or radiographic evidence of ongoing hemodynamic compromise. Five patients underwent successful intracranial angioplasty and stent placement and 2 patients underwent successful intracranial balloon angioplasty alone. The mean time from documented vessel occlusion to treatment was 35 days. All patients had successful revascularization determined using the Thrombolysis in Cerebral Infarction (TICI) scale: TICI Score 3, 2b, and 2a in 4, 2, and 1 patient, respectively, and the mean residual stenosis was 38%.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n After uneventful technical procedures, 1 patient suffered a perforator vessel stroke and 1 patient suffered a fatal hemorrhage. Mean modified Rankin Scale score of 2 (range 1\u20135) and mean Glasgow Outcome Scale score of 4 (range 1\u20136) were achieved during a mean clinical follow-up period of 399 days (range 1\u2013840 days). Asymptomatic restenosis was documented in 4 patients, 1 underwent bypass retreatment, and 1 patient received repeated balloon angioplasty.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Combined intracranial angioplasty and stent placement is a potential treatment option in selected patients for the direct revascularization of nonacute intracranial occlusions and near occlusions. Whether this represents a substantial risk reduction compared with the best medical therapy or a long-lasting treatment option is unknown.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2008.12.focus08269","type":"journal-article","created":{"date-parts":[[2009,2,27]],"date-time":"2009-02-27T10:34:16Z","timestamp":1235730856000},"page":"E3","source":"Crossref","is-referenced-by-count":9,"title":["Intracranial angioplasty and stent placement for direct cerebral revascularization of nonacute intracranial occlusions and near occlusions"],"prefix":"10.3171","volume":"26","author":[{"given":"Max","family":"Kole","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beejal","family":"Amin","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horia","family":"Marin","sequence":"additional","affiliation":[{"name":"Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Russman","sequence":"additional","affiliation":[{"name":"Neurology, Henry Ford Health System, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Sanders","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0260003","series-title":"Circulation","first-page":"1167","article-title":"Guidelines for thrombolytic therapy for acute stroke: a supplement to the guidelines for the management of patients with acute ischemic stroke","volume":"94","author":"Adams","year":"1996"},{"key":"b2-0260003","series-title":"Stroke","first-page":"1497","article-title":"Modification of Rankin scale: recovery of motor function after stroke","volume":"19","author":"Bonita","year":"1988"},{"key":"b3-0260003","series-title":"Stroke","first-page":"1531","article-title":"A novel, self-expanding, nitinol stent in medically refractory intracranial atherosclerotic stenoses: the Wingspan study","volume":"38","author":"Bose","year":"2007"},{"key":"b4-0260003","series-title":"Cardiovasc Intervent Radiol","first-page":"447","article-title":"Percutaneous endovascular treatment of chronic iliac artery occlusion","volume":"27","author":"Carnevale","year":"2004"},{"key":"b5-0260003","series-title":"Neuroimaging Clin N Am","first-page":"303","article-title":"Mechanisms of ischemic stroke secondary to large artery atherosclerotic disease","volume":"17","author":"Derdeyn","year":"2007"},{"key":"b6-0260003","series-title":"Neurology","first-page":"251","article-title":"Cerebral hemodynamic impairment: Methods of measurement and association with stroke risk","volume":"53","author":"Derdeyn","year":"1999"},{"key":"b7-0260003","series-title":"Skull Base","first-page":"7","article-title":"Indications for cerebral revascularization for patients with atherosclerotic carotid occlusion","volume":"15","author":"Derdeyn","year":"2005"},{"key":"b8-0260003","series-title":"Stroke","first-page":"1025","article-title":"Lack of correlation between pattern of collateralization and misery perfusion in patients with carotid occlusion","volume":"30","author":"Derdeyn","year":"1999"},{"key":"b9-0260003","series-title":"Neurosurgery","first-page":"236","article-title":"A 7-year experience with balloon mounted coronary stents for the treatment of symptomatic vertebrobasilar intracranial atheromatous disease","volume":"61","author":"Fiorella","year":"2007"},{"key":"b10-0260003","series-title":"Stroke","first-page":"881","article-title":"US multicenter experience with the Wingspan stent system for the treatment of intracranial atheromatous disease: periprocedural results","volume":"38","author":"Fiorella","year":"2007"},{"key":"b11-0260003","series-title":"JAMA","first-page":"2003","article-title":"Intra-arterial prourokinase for acute ischemic stroke. The ProACT II study: a randomized controlled trial. Prolyse in Acute Cerebral Thromboembolism","volume":"282","author":"Furlan","year":"1999"},{"key":"b12-0260003","series-title":"JAMA","first-page":"1055","article-title":"Importance of hemodynamic factors in the prognosis of symptomatic carotid occlusion","volume":"280","author":"Grubb","year":"1998"},{"key":"b13-0260003","series-title":"N Engl J Med","first-page":"1317","article-title":"Thrombolytics with alteplase 3 to 4.5 hours after acute ischemic stroke","volume":"359","author":"Hacke","year":"2008"},{"key":"b14-0260003","series-title":"Stroke","first-page":"1216","article-title":"Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease","volume":"19","author":"Hacke","year":"1988"},{"key":"b15-0260003","series-title":"Neuroradiology","first-page":"222","article-title":"Treatment of intracranial atherosclerotic stenoses with balloon dilatation and self-expanding stent deployment (Wingspan)","volume":"47","author":"Henkes","year":"2005"},{"key":"b16-0260003","series-title":"Stroke","first-page":"e109","article-title":"Technological Assessment Committee of the American Society of Interventional and Therapeutic Neuroradiology, Technological Assessment of the Society of Interventional Radiology: trial design and reporting standards for intra-arterial cerebral thrombolysis for acute ischemic stroke","volume":"34","author":"Higashida","year":"2003"},{"key":"b17-0260003","series-title":"J Endovasc Ther","first-page":"254","article-title":"Successful stenting seven days after atherothrombotic occlusion of the intracranial internal carotid artery","volume":"13","author":"Imai","year":"2006"},{"key":"b18-0260003","series-title":"Lancet","first-page":"480","article-title":"Assessment of outcome after severe brain damage. A practical scale","volume":"1","author":"Jennett","year":"1975"},{"key":"b19-0260003","series-title":"Circulation","first-page":"555","article-title":"for the Warfarin Aspirin Symptomatic Intracranial Disease (WASID) Trial Investigators: predictors of ischemic stroke in the territory of a symptomatic intracranial arterial stenosis","volume":"113","author":"Kasner","year":"2006"},{"key":"b20-0260003","series-title":"Stroke","first-page":"2110","article-title":"Long-term prognosis of medically treated patients with internal carotid or middle cerebral artery occlusion","volume":"32","author":"Kuroda","year":"2001"},{"key":"b21-0260003","series-title":"Catheter Cardiovasc Interv","first-page":"558","article-title":"Percutaneous recanalization of chronic subclavian artery occlusion using optical coherence reflectometry-guided radiofrequency ablation guidewire","volume":"60","author":"Lee","year":"2003"},{"key":"b22-0260003","series-title":"Neurology","first-page":"25","article-title":"Cerebral vasocapacitance and TIAs","volume":"39","author":"Levine","year":"1989"},{"key":"b23-0260003","series-title":"Neurosurgery","first-page":"539","article-title":"Factors affecting survival rates for acute vertebrobasilar artery occlusions treated with intra-arterial thrombolytic therapy: a meta-analytical approach","volume":"45","author":"Levy","year":"1999"},{"key":"b24-0260003","series-title":"AJNR Am J Neuroradiol","first-page":"816","article-title":"Self-expanding stents for recanalization of acute cerebrovascular occlusions","volume":"28","author":"Levy","year":"2007"},{"key":"b25-0260003","series-title":"Neurology","first-page":"911","article-title":"The risks and benefits of carotid endarterectomy in patients with near occlusion of the carotid artery: North American Symptomatic Carotid Endarterectomy Trial (NASCET) group","volume":"48","author":"Morgenstern","year":"1997"},{"key":"b26-0260003","series-title":"N Engl J Med","first-page":"1581","article-title":"Tissue plasminogen activator for acute ischemic stroke","volume":"333","author":"The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group","year":"1995"},{"key":"b27-0260003","series-title":"Ann Intern Med","first-page":"27","article-title":"The effect of hemodynamically significant carotid artery disease on the hemodynamic status of the cerebral circulation","volume":"106","author":"Powers","year":"1987"},{"key":"b28-0260003","series-title":"Lancet","first-page":"107","article-title":"Carotid Endarterectomy Trialists' Collaboration: analysis of pooled data from the randomized controlled trials of endarterectomy for symptomatic carotid stenosis","volume":"361","author":"Rothwell","year":"2003"},{"key":"b29-0260003","series-title":"Stroke","first-page":"14","article-title":"Race-ethnicity and determinants of 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stenosis","volume":"29","author":"The Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Study Group","year":"1998"},{"key":"b34-0260003","series-title":"Neurology","first-page":"490","article-title":"Symptomatic intracranial atherosclerosis: outcome of patients who fail antithrombotic therapy","volume":"55","author":"Thijs","year":"2000"},{"key":"b35-0260003","series-title":"AJNR Am J Neuroradiol","first-page":"168","article-title":"Stenting and angioplasty of the symptomatic chronically occluded carotid artery","volume":"28","author":"Thomas","year":"2007"},{"key":"b36-0260003","series-title":"AJNR Am J Neuroradiol","first-page":"23","article-title":"Influence of patient age and stenosis location on wingspan in-stent restenosis","volume":"29","author":"Turk","year":"2008"},{"key":"b37-0260003","series-title":"Ann Neurol","first-page":"167","article-title":"Role of collateral flow on cerebral hemodynamics in patients with unilateral internal carotid artery occlusion","volume":"44","author":"van Everdingen","year":"1998"},{"key":"b38-0260003","series-title":"Stroke","first-page":"1974","article-title":"Race and sex differences in the distribution of cerebral atherosclerosis","volume":"27","author":"Wityk","year":"1996"},{"key":"b39-0260003","series-title":"AJNR Am J Neuroradiol","first-page":"1882","article-title":"Intracranial angioplasty and stenting: long-term results from a single center","volume":"27","author":"Wojak","year":"2006"},{"key":"b40-0260003","series-title":"Neurology","first-page":"1518","article-title":"For the NIH Multi-center Wingspan Intracranial Stent Registry Study Group: the NIH registry on use of the Wingspan stent for symptomatic 70-99% intracranial arterial stenosis","volume":"70","author":"Zaidat","year":"2008"},{"key":"b1-0260003","series-title":"Circulation","first-page":"1167","article-title":"Guidelines for thrombolytic therapy for acute stroke: a supplement to the guidelines for the management of patients 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disease","volume":"17","author":"Derdeyn","year":"2007"},{"key":"b6-0260003","series-title":"Neurology","first-page":"251","article-title":"Cerebral hemodynamic impairment: Methods of measurement and association with stroke risk","volume":"53","author":"Derdeyn","year":"1999"},{"key":"b7-0260003","series-title":"Skull Base","first-page":"7","article-title":"Indications for cerebral revascularization for patients with atherosclerotic carotid occlusion","volume":"15","author":"Derdeyn","year":"2005"},{"key":"b8-0260003","series-title":"Stroke","first-page":"1025","article-title":"Lack of correlation between pattern of collateralization and misery perfusion in patients with carotid occlusion","volume":"30","author":"Derdeyn","year":"1999"},{"key":"b9-0260003","series-title":"Neurosurgery","first-page":"236","article-title":"A 7-year experience with balloon mounted coronary stents for the treatment of symptomatic vertebrobasilar intracranial atheromatous disease","volume":"61","author":"Fiorella","year":"2007"},{"key":"b10-0260003","series-title":"Stroke","first-page":"881","article-title":"US multicenter experience with the Wingspan stent system for the treatment of intracranial atheromatous disease: periprocedural results","volume":"38","author":"Fiorella","year":"2007"},{"key":"b11-0260003","series-title":"JAMA","first-page":"2003","article-title":"Intra-arterial prourokinase for acute ischemic stroke. The ProACT II study: a randomized controlled trial. Prolyse in Acute Cerebral Thromboembolism","volume":"282","author":"Furlan","year":"1999"},{"key":"b12-0260003","series-title":"JAMA","first-page":"1055","article-title":"Importance of hemodynamic factors in the prognosis of symptomatic carotid occlusion","volume":"280","author":"Grubb","year":"1998"},{"key":"b13-0260003","series-title":"N Engl J Med","first-page":"1317","article-title":"Thrombolytics with alteplase 3 to 4.5 hours after acute ischemic stroke","volume":"359","author":"Hacke","year":"2008"},{"key":"b14-0260003","series-title":"Stroke","first-page":"1216","article-title":"Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease","volume":"19","author":"Hacke","year":"1988"},{"key":"b15-0260003","series-title":"Neuroradiology","first-page":"222","article-title":"Treatment of intracranial atherosclerotic stenoses with balloon dilatation and self-expanding stent deployment (Wingspan)","volume":"47","author":"Henkes","year":"2005"},{"key":"b16-0260003","series-title":"Stroke","first-page":"e109","article-title":"Technological Assessment Committee of the American Society of Interventional and Therapeutic Neuroradiology, Technological Assessment of the Society of Interventional Radiology: trial design and reporting standards for intra-arterial cerebral thrombolysis for acute ischemic stroke","volume":"34","author":"Higashida","year":"2003"},{"key":"b17-0260003","series-title":"J Endovasc Ther","first-page":"254","article-title":"Successful stenting seven days after atherothrombotic occlusion of the intracranial internal carotid artery","volume":"13","author":"Imai","year":"2006"},{"key":"b18-0260003","series-title":"Lancet","first-page":"480","article-title":"Assessment of outcome after severe brain damage. A practical scale","volume":"1","author":"Jennett","year":"1975"},{"key":"b19-0260003","series-title":"Circulation","first-page":"555","article-title":"for the Warfarin Aspirin Symptomatic Intracranial Disease (WASID) Trial Investigators: predictors of ischemic stroke in the territory of a symptomatic intracranial arterial stenosis","volume":"113","author":"Kasner","year":"2006"},{"key":"b20-0260003","series-title":"Stroke","first-page":"2110","article-title":"Long-term prognosis of medically treated patients with internal carotid or middle cerebral artery occlusion","volume":"32","author":"Kuroda","year":"2001"},{"key":"b21-0260003","series-title":"Catheter Cardiovasc Interv","first-page":"558","article-title":"Percutaneous recanalization of chronic subclavian artery occlusion using optical coherence reflectometry-guided radiofrequency ablation guidewire","volume":"60","author":"Lee","year":"2003"},{"key":"b22-0260003","series-title":"Neurology","first-page":"25","article-title":"Cerebral vasocapacitance and TIAs","volume":"39","author":"Levine","year":"1989"},{"key":"b23-0260003","series-title":"Neurosurgery","first-page":"539","article-title":"Factors affecting survival rates for acute vertebrobasilar artery occlusions treated with intra-arterial thrombolytic therapy: a meta-analytical approach","volume":"45","author":"Levy","year":"1999"},{"key":"b24-0260003","series-title":"AJNR Am J Neuroradiol","first-page":"816","article-title":"Self-expanding stents for recanalization of acute cerebrovascular occlusions","volume":"28","author":"Levy","year":"2007"},{"key":"b25-0260003","series-title":"Neurology","first-page":"911","article-title":"The risks and benefits of carotid endarterectomy in patients with near occlusion of the carotid artery: North American Symptomatic Carotid Endarterectomy Trial (NASCET) group","volume":"48","author":"Morgenstern","year":"1997"},{"key":"b26-0260003","series-title":"N Engl J Med","first-page":"1581","article-title":"Tissue plasminogen activator for acute ischemic stroke","volume":"333","author":"The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group","year":"1995"},{"key":"b27-0260003","series-title":"Ann Intern Med","first-page":"27","article-title":"The effect of hemodynamically significant carotid artery disease on the hemodynamic status of the cerebral circulation","volume":"106","author":"Powers","year":"1987"},{"key":"b28-0260003","series-title":"Lancet","first-page":"107","article-title":"Carotid Endarterectomy Trialists' Collaboration: analysis of pooled data from the randomized controlled trials of endarterectomy for symptomatic carotid stenosis","volume":"361","author":"Rothwell","year":"2003"},{"key":"b29-0260003","series-title":"Stroke","first-page":"14","article-title":"Race-ethnicity and determinants of intracranial atherosclerotic cerebral infarction: the Northern Manhattan Stroke Study","volume":"26","author":"Sacco","year":"1995"},{"key":"b30-0260003","series-title":"AJNR Am J Neuroradiol","first-page":"643","article-title":"A standardized method for measuring intracranial arterial stenosis","volume":"21","author":"Samuels","year":"2000"},{"key":"b31-0260003","series-title":"Stroke","first-page":"1205","article-title":"Mechanical thrombectomy for acute ischemic stroke: final results of the Multi Merci trial","volume":"39","author":"Smith","year":"2008"},{"key":"b32-0260003","series-title":"Stroke","first-page":"1388","article-title":"Stenting of symptomatic atherosclerotic lesions in the vertebral or intracranial arteries (SSYLVIA): study results","volume":"35","author":"The SSYLVIA study investigators","year":"2004"},{"key":"b33-0260003","series-title":"Stroke","first-page":"1389","article-title":"Prognosis of patients with symptomatic vertebral or basilar artery 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