Introduction: Acute ischemic stroke (AIS) is the third leading cause of death. Arterial stenosis is a common cause of stroke, with a high risk of recurrent stroke. Treatment guidelines for AIS and transient ischemic attack (TIA) are still under debate. Treatment guidelines for progressive stroke or crescendo TIA's do not exist. Percutaneous transluminal angioplasty and stenting (PTAS) is an increasingly attractive treatment option, whose efficacy is to be proven. Stent placement however possess both short and long term risks such as immediate ischemic events, in-stent stenosis and stent breakage. Thus, the choice of stent type is critical. We report our experience with the LEO + (Balt Extrusion, Montmorency, France) nitinol flexible self-expanding stent for the treatment of progressive CVA or crescendo TIA's.
Methods: 12 patients, presenting with a clinical picture of a crescendo TIA or progressive stroke in evolution, not halted by optimal medical care were treated. Patients had a corresponding major cerebral arterial narrowing and evidence of cerebral infarction on imaging. Patients were followed clinically and radiographically.
Results: Twelve patients aged 17~80 years were treated during the study period (20 months). Sixteen Nitinol flexible self-expandable stent (LEO +, Balt Extrusion, Montmorency, France) were placed. All patients showed moderate to substantial improvement in neurological functions after the procedure.
Conclusions: PTAS should be considered as a treatment option in case of progressive stroke or crescendo TIA's coupled with appropriate anatomical findings. This may allow for a substantial improvement in functional and neurological status.
Patient Care: An alternative treatment option for patients with crescendo acute ischemic stroke or TIA.
Learning Objectives: We report our experience with Nitinol flexible self-expanding stent (LEO +, Balt Extrusion, Montmorency, France) for the treatment of acute crescendo TIA's and progressive AIS.
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