Conclusions

Intracranial stent angioplasty has emerged as a technically feasible and useful adjunct to treatment of both severe intracranial atherosclerosis and geometrically challenging aneurysms. Newer stent designs specifically tailored for the treatment of intracranial lesions have been developed and are in current clinical trials. The current data available from a growing number of retrospective series and case reports continue to highlight the high risk of these procedures. These same reports have also illustrated significant clinical successes in well-selected cases that would not have been achievable using alternate therapies. Consequently, intracranial stent angioplasty should be limited to the treatment of patients who have failed conventional modes of therapy in select centers with high caseloads and expertise until results from randomized trials become available. The continued improvement of the currently available microstent designs will undoubtedly lead to improved clinical outcomes in the future.

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