01-12-2016 | Editorial
Intracranial Stenting in Germany
The Reimbursement Decision has been made, but the Scientific Debate Continues
Published in: Clinical Neuroradiology | Issue 4/2016
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The results of the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) [1] and the Vitesse Stent Ischemic Therapy trial (VISSIT) [2] have changed the current clinical and reimbursement practice in the endovascular treatment of intracranial atherosclerotic disease (ICAD) for stroke prevention. After the initial clinical alert, due to the termination of the SAMMPRIS trial on 11 April 2011 the National Institute of Neurological Disorders and Stroke (NINDS) restricted reimbursement of intracranial stenting with the Wingspan stent to patients:-
between 22 and 80 years of age,
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who have had two or more strokes despite aggressive medical treatment, if the most recent stroke occurred more than 7 days prior to a planned Wingspan treatment,
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who have a stenosis >70% and have shown a recovery from previous stroke (modified Rankin scale [mRS] ≤ 3).
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Furthermore, the Wingspan Stent System should not be used for the treatment of transient ischemic attacks (TIA).