Role of Stenting for Intracranial Atherosclerosis in the Post-SAMMPRIS Era

Introduction. The initial promise of endovascular stenting for the treatment of intracranial atherosclerotic disease (ICAD) has been tempered by the results of the SAMMPRIS trial which demonstrated better outcomes with medical management compared to stenting for symptomatic ICAD. We review post-SAMMPRIS ICAD stenting outcomes. Methods. A comprehensive literature search was performed using PubMed to identify all ICAD stenting series published after the SAMMPRIS in September 2011. The type and design of the stent, number of patients and lesions, inclusion criteria, and clinical and angiographic outcomes were noted. Results. From October 2011 to August 2013, 19 ICAD stenting series were identified describing the interventional outcomes for 2,196 patients with 2,314 lesions. Of the 38 different stents used, 87% were balloon-expandable stents (BESs) and 13% were self-expanding stents. The median minimum stenosis was 50%. The median rates of technical success rate, postprocedural ischemic events, and symptomatic in-stent restenosis (ISR) were 98% (range 87–100%), 9.4% (range 0–25%), and 2.7% (range 0–11.1%), respectively. The median follow-up durations were one to 67 months. Conclusions. The management of severe ICAD remains controversial. Future trials are needed to define the optimal patient, lesion, and stent characteristics which will portend the best outcomes with intervention

Mid-infrared selection of AGN

Since a large fraction of active galactic nuclei (AGN) is missed in common UV-excess surveys and is even hard to find in radio, near-IR and X-ray surveys, we have used a new AGN selection technique which is expected to be not affected by extinction. Within the scientific verification of the ISOCAM Parallel Survey at 6.7 micron we have discovered objects with exceptional mid-infrared (MIR) emission. They are essentially not detected on IRAS-ADDSCANs and only very few of them show up in the NVSS and FIRST radio surveys. Various colour criteria of the 6.7 micron data with 2MASS and optical wavebands show that the sources reach more extreme IR colours than the sources in the Hubble Deep Field-South and the ELAIS survey. The comparison with known object types suggests that we have found AGN with a pronounced MIR emission, probably due to circum-nuclear dust. First results from optical spectroscopy of ten candidates corroborate this interpretation showing four AGN, two reddened LINER and four extremely reddened emission-line galaxies with MIR/FIR flux ratios higher than for known pure starburst galaxies. The results will make a significant contribution to the debate on the entire AGN population.Comment: 4 pages, 2 figures, accepted for publication as Letter in Astronomy & Astrophysic