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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 CVA 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 posses 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. Advances in
stent technology have made cerebral stent placement a viable option. 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.
12 patients, presenting with an evolving clinical picture of crescendo TIA or progressive CVA not halted by optimal
medical care, were treated. Patients had a corresponding arterial first generation arterial narrowing and evidence of cerebral
infarction on imaging. Patients were followed clinically and radiologically.
Twelve patients aged 17~75 years were treated during the study period (20 months). Sixteen Nitinol flexible self expanding
stent (LEO +, Balt Extrusion, Montmorency, France) were placed. All patients showed moderate to substaintial improvement in
neurological functioning after the procedure.
PTAS should be considered as a treatment option in case of progressive CVA or crescendo TIA's and appropriate
anatomical findings with substanial improvement in functional and neurological status.
Or Cohen-Inbar has completed his M.D. at the Technion Israel institute of technology, currently completing his Ph.D studies at the field of molecular
immunology and cancer immunotherapy. He is a 5
year resident of neurosurgery at the department of neurosurgery at Rambam health care
campus. He is a member of both the Congress of neurological surgeons and the EANS, and has published over 6peer review papers in both clinical
and basic science fields.
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