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Long-term clinical and angiographic outcome from angioplasty and stenting for intracranial stenosis

Authors
 Sang Kyu Park  ;  Sang Hyun Suh  ;  Kyeong Sool Jang  ;  Dong Kyu Jang  ;  Dong Young Jo  ;  Yong Sam Shin 
Citation
 ACTA NEUROCHIRURGICA, Vol.164(6) : 1627-1634, 2022-06 
Journal Title
ACTA NEUROCHIRURGICA
ISSN
 0001-6268 
Issue Date
2022-06
MeSH
Angioplasty / adverse effects ; Constriction, Pathologic / diagnostic imaging ; Constriction, Pathologic / surgery ; Humans ; Intracranial Arteriosclerosis* / diagnostic imaging ; Intracranial Arteriosclerosis* / surgery ; Stents / adverse effects ; Stroke* / etiology ; Treatment Outcome ; United States
Keywords
Intracranial atherosclerotic stenosis (ICAS) ; Long-term outcome ; Major cerebral artery ; Percutaneous transluminal angioplasty and stenting (PTAS) ; Stroke
Abstract
Background: Severe intracranial atherosclerotic stenosis (ICAS) is a major cause of stroke. Although percutaneous transluminal angioplasty and stenting (PTAS) treatment methods have increased over the last decade as alternative therapies, there is debate regarding the best method of treatment, with medical and surgical therapies often suggested.

Methods: We analyzed the long-term follow-up results from 5 years of intracranial stenting for intracranial stenosis from three stroke centers. The primary endpoints were early stroke complications or death within 30 days after stent insertion, and the secondary endpoint was a recurrent stroke between 30 days and 60 months. Correlating factors and Kaplan-Meier survival curves for recurrent stroke and in-stent restenosis (ISR) were also obtained.

Results: Seventy-three PTAS in 71 patients were examined in this study. The primary and secondary endpoints were all 8.2% (n = 6), and restenosis was 13.7% (n = 10) during the 5-year follow-up. The primary endpoints were significantly frequent in the high National Institutes of Health Stroke Scale (NIHSS) and early stent (≤ 7 days after dual antiplatelet medication) groups. Secondary endpoint and ISR were identically frequent in the younger age group and in the presence of tandem stenosis in other major intracranial arteries. The cumulative probability of recurrent stroke and ISR at 60 months was 16.4% and 14.1%, respectively.

Conclusions: This study shows that PTAS is safe and effective for major ICAS. Reducing the early complication rate is still an important factor, despite the fact that long-term stroke recurrence was low.
Full Text
https://link.springer.com/article/10.1007/s00701-022-05110-3
DOI
10.1007/s00701-022-05110-3
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Park, Sang Kyu(박상규)
Suh, Sang Hyun(서상현) ORCID logo https://orcid.org/0000-0002-7098-4901
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/189312
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