• Azeem A Rehman, Ryan C Turner, Brandon P Lucke-Wold, and SoHyun Boo.
• Department of Neurosurgery, West Virginia University School of Medicine, Morgantown, West Virginia, USA.
• World Neurosurg. 2017 Jun 1; 102: 693.e15-693.e19.

BackgroundIntracranial arterial atherosclerosis represents a common cause of stroke. Despite aggressive and optimal medical management, many patients will unfortunately suffer additional cerebrovascular events. The role of endovascular intervention for intracranial atherosclerotic disease continues to be uncertain, particularly in regard to extensive, symptomatic stenosis.Case DescriptionWe present a case of a 42-year-old man with a complex medical history who presented with recurrent ischemic stroke in the ipsilateral hemisphere despite optimal medical management. Given the length of stenosis and the luminal size of the intracranial cavernous and petrous segments of the internal carotid artery, we used a bare metal coronary stent (4.0 mm × 24 mm). This represents one of the longest stents deployed for intracranial disease reported in the literature.ConclusionsThis case illustrates that a long coronary stent might be successfully used to manage extensive intracranial lesions. We also review the efficacy of using 1 very long stent versus multiple overlapping stents, with reference to the coronary angiography literature.Copyright © 2017 Elsevier Inc. All rights reserved.

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