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AJNR Am J Neuroradiol. 2008 Apr;29(4):781-5. doi: 10.3174/ajnr.A0922. Epub 2008 Feb 29.

Intracranial stenting of severe symptomatic intracranial stenosis: results of 100 consecutive patients.

Author information

1
Department of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, 388-One Pungnap-2 Dong, Songpa-Gu, Seoul 138-736, Korea. dcsuh@amc.seoul.kr

Abstract

BACKGROUND AND PURPOSE:

There are a few reports regarding the outcome evaluation of balloon-expandable intracranial stent placement (BEICS). The purpose of our study was to evaluate the outcome and factors related to the adverse events (AEs) of BEICS.

MATERIALS AND METHODS:

We evaluated 100 consecutive patients who underwent BEICS. We assessed the procedural success (residual stenosis < 50%), AEs (minor strokes, major strokes, and death), clinical outcome, and restenosis (> 50%) at 6 months. We also analyzed 18 factors including symptom patterns related to AE rate. Symptom patterns revealed 1) stable patients (n = 73) with improving, stationary, or resolved symptoms; and 2) unstable patients (n = 27) with gradual worsening or fluctuating symptoms (National Institutes of Health Stroke Scale [NIHSS] > or = 4) within 2 days before stent placement.

RESULTS:

The procedural success rate was 99%. Overall, there were 10 (10%) AEs within the 6 months: 4 (4%) minor strokes, 3 (3%) major strokes, and 3 (3%) deaths including a death from myocardial infarction. AE rate was 4.1% in stable and 25.9% in unstable patients. Restenosis at 6 months revealed 0% (0/59). Good outcome (modified Rankin Scale < or = 2) at 6 months was 97% (71/73) in stable and 67% (18/27) in unstable patients. Stepwise logistic regression model revealed that symptom pattern (unstable versus stable) was the only significant risk factor (OR, 8.167; 95% CI, 1.933-34.500; P = .004).

CONCLUSION:

BEICS revealed a low AE and good outcome rate at 6 months, especially in the stable patients. Midterm outcome was also favorable in the unstable patient group.

PMID:
18310234
DOI:
10.3174/ajnr.A0922
[Indexed for MEDLINE]
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