Limits...
Wingspan Stenting for Severe Symptomatic Intracranial Atherosclerotic Stenosis in 433 Patients Treated at a Single Medical Center.

Li TX, Gao BL, Cai DY, Wang ZL, Zhu LF, Xue JY, Bai WX, He YK, Li L - PLoS ONE (2015)

Bottom Line: The total perioperative stroke rate was significantly (P < 0.01) higher in the basilar artery area than in others, whereas the hemorrhagic stroke rate was significantly (P < 0.05) greater in the middle cerebral artery area than in others.The experience accumulation stage (13%) had a significantly (P < 0.05) higher stroke rate than the technical maturation stage (4.8%).The one- and two-year cumulative stroke rates were 9.5% and 11.5%, respectively; the two-year cumulative stroke rate was significantly (P < 0.05) greater in the experience accumulation stage (18.8%) than in the technical maturation stage (9.1%).

View Article: PubMed Central - PubMed

Affiliation: Stroke Center, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, Henan Province, China.

ABSTRACT

Purpose: To investigate the safety and outcome of intracranial stenting for intracranial atherosclerotic stenosis (IAS).

Materials and methods: Between July 2007 and April 2013, 433 consecutive patients with IAS > 70% underwent intracranial Wingspan stenting, and the data were prospectively analyzed.

Results: Intracranial stenting was successful in 429 patients (99.1%), and the mean stenosis rate was improved from prestenting (82.3 ± 7.6)% to poststenting (16.6 ± 6.6)%. During the 30-day perioperative period, 29 patients (6.7%) developed stroke. The total perioperative stroke rate was significantly (P < 0.01) higher in the basilar artery area than in others, whereas the hemorrhagic stroke rate was significantly (P < 0.05) greater in the middle cerebral artery area than in others. The experience accumulation stage (13%) had a significantly (P < 0.05) higher stroke rate than the technical maturation stage (4.8%). Clinical follow-up 6-69 months poststenting revealed ipsilateral stroke in 20 patients (5.5%). The one- and two-year cumulative stroke rates were 9.5% and 11.5%, respectively; the two-year cumulative stroke rate was significantly (P < 0.05) greater in the experience accumulation stage (18.8%) than in the technical maturation stage (9.1%).

Conclusion: Wingspan stenting for intracranial atherosclerotic stenosis is safe and the long-term stroke rate after stenting is low in a Chinese subpopulation.

No MeSH data available.


Related in: MedlinePlus

Perioperative complications with respect to the experience accumulation and technical maturation stages.ICH, intracerebral hemorrhage; SAH, subarachnoid hemorrhage; FDI, fatal/disabling ischemic stroke; FDH, fatal/disabling hemorrhage.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4589313&req=5

pone.0139377.g001: Perioperative complications with respect to the experience accumulation and technical maturation stages.ICH, intracerebral hemorrhage; SAH, subarachnoid hemorrhage; FDI, fatal/disabling ischemic stroke; FDH, fatal/disabling hemorrhage.

Mentions: During the 30-day perioperative period, 29 patients (6.7%; 29/433) developed stroke or died, including 21 cases (4.8%) of ischemic stroke and eight (1.8%) hemorrhagic stroke. In addition, there were seven patients (1.6%) of fatal or disabling stroke, including three cases of death and four severe disability (Tables 3 and 4 and Fig 1). The perioperative stroke incidence was significantly greater in the experience accumulation stage than in the technical maturation stage (13% vs. 4.8%; p = 0.007). Specifically, the rates of hemorrhagic stroke, thrombotic stroke, ischemic and fatal/disabling stroke, and total fatal/disabling stroke were all significantly higher in the first stage than in the second stage (p = 0.018, p = 0.018, p = 0.04, and p = 0.008, respectively). The incidence of perforator stroke did not differ between the two stages (3% vs. 3%; p = 1.000).


Wingspan Stenting for Severe Symptomatic Intracranial Atherosclerotic Stenosis in 433 Patients Treated at a Single Medical Center.

Li TX, Gao BL, Cai DY, Wang ZL, Zhu LF, Xue JY, Bai WX, He YK, Li L - PLoS ONE (2015)

Perioperative complications with respect to the experience accumulation and technical maturation stages.ICH, intracerebral hemorrhage; SAH, subarachnoid hemorrhage; FDI, fatal/disabling ischemic stroke; FDH, fatal/disabling hemorrhage.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4589313&req=5

pone.0139377.g001: Perioperative complications with respect to the experience accumulation and technical maturation stages.ICH, intracerebral hemorrhage; SAH, subarachnoid hemorrhage; FDI, fatal/disabling ischemic stroke; FDH, fatal/disabling hemorrhage.
Mentions: During the 30-day perioperative period, 29 patients (6.7%; 29/433) developed stroke or died, including 21 cases (4.8%) of ischemic stroke and eight (1.8%) hemorrhagic stroke. In addition, there were seven patients (1.6%) of fatal or disabling stroke, including three cases of death and four severe disability (Tables 3 and 4 and Fig 1). The perioperative stroke incidence was significantly greater in the experience accumulation stage than in the technical maturation stage (13% vs. 4.8%; p = 0.007). Specifically, the rates of hemorrhagic stroke, thrombotic stroke, ischemic and fatal/disabling stroke, and total fatal/disabling stroke were all significantly higher in the first stage than in the second stage (p = 0.018, p = 0.018, p = 0.04, and p = 0.008, respectively). The incidence of perforator stroke did not differ between the two stages (3% vs. 3%; p = 1.000).

Bottom Line: The total perioperative stroke rate was significantly (P < 0.01) higher in the basilar artery area than in others, whereas the hemorrhagic stroke rate was significantly (P < 0.05) greater in the middle cerebral artery area than in others.The experience accumulation stage (13%) had a significantly (P < 0.05) higher stroke rate than the technical maturation stage (4.8%).The one- and two-year cumulative stroke rates were 9.5% and 11.5%, respectively; the two-year cumulative stroke rate was significantly (P < 0.05) greater in the experience accumulation stage (18.8%) than in the technical maturation stage (9.1%).

View Article: PubMed Central - PubMed

Affiliation: Stroke Center, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, Henan Province, China.

ABSTRACT

Purpose: To investigate the safety and outcome of intracranial stenting for intracranial atherosclerotic stenosis (IAS).

Materials and methods: Between July 2007 and April 2013, 433 consecutive patients with IAS > 70% underwent intracranial Wingspan stenting, and the data were prospectively analyzed.

Results: Intracranial stenting was successful in 429 patients (99.1%), and the mean stenosis rate was improved from prestenting (82.3 ± 7.6)% to poststenting (16.6 ± 6.6)%. During the 30-day perioperative period, 29 patients (6.7%) developed stroke. The total perioperative stroke rate was significantly (P < 0.01) higher in the basilar artery area than in others, whereas the hemorrhagic stroke rate was significantly (P < 0.05) greater in the middle cerebral artery area than in others. The experience accumulation stage (13%) had a significantly (P < 0.05) higher stroke rate than the technical maturation stage (4.8%). Clinical follow-up 6-69 months poststenting revealed ipsilateral stroke in 20 patients (5.5%). The one- and two-year cumulative stroke rates were 9.5% and 11.5%, respectively; the two-year cumulative stroke rate was significantly (P < 0.05) greater in the experience accumulation stage (18.8%) than in the technical maturation stage (9.1%).

Conclusion: Wingspan stenting for intracranial atherosclerotic stenosis is safe and the long-term stroke rate after stenting is low in a Chinese subpopulation.

No MeSH data available.


Related in: MedlinePlus