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

Kaplan-Meier estimation of the cumulative stroke rate.The stroke incidences during the experience accumulation and technical maturation stages have been compared. The former stage yielded a one-year cumulative stroke rate (including all cases of stroke or death within the 30-day perioperative period and all cases of ipsilateral stroke after that period) of 15.7% (95% CI: 8.3–23.1%) and a two-year cumulative stroke rate of 18.8% (95% CI: 10.6–27.0%). The latter stage generated a one-year cumulative stroke rate (including all cases of stroke or death within the 30-day perioperative period and all cases of ipsilateral stroke after that period) of 7.7% (95% CI: 4.8–10.6%) and a two-year cumulative stroke rate of 9.1% (95% CI: 5.8–12.4%). The Kaplan-Meier plots differed significantly according to the log-rank test (X2 = 4.735, p = 0.030). Green curve: Experience accumulation stage. Blue curve: Technical maturation stage.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0139377.g003: Kaplan-Meier estimation of the cumulative stroke rate.The stroke incidences during the experience accumulation and technical maturation stages have been compared. The former stage yielded a one-year cumulative stroke rate (including all cases of stroke or death within the 30-day perioperative period and all cases of ipsilateral stroke after that period) of 15.7% (95% CI: 8.3–23.1%) and a two-year cumulative stroke rate of 18.8% (95% CI: 10.6–27.0%). The latter stage generated a one-year cumulative stroke rate (including all cases of stroke or death within the 30-day perioperative period and all cases of ipsilateral stroke after that period) of 7.7% (95% CI: 4.8–10.6%) and a two-year cumulative stroke rate of 9.1% (95% CI: 5.8–12.4%). The Kaplan-Meier plots differed significantly according to the log-rank test (X2 = 4.735, p = 0.030). Green curve: Experience accumulation stage. Blue curve: Technical maturation stage.

Mentions: The experience accumulation stage had a one-year cumulative stroke rate (including all cases of stroke or death within the 30-day perioperative period and all cases of ipsilateral stroke after this period) of 15.7% (95% CI: 8.3–23.1%) and a two-year cumulative stroke rate of 18.8% (95% CI: 10.6–27.0%) (Fig 3). In comparison, the technical maturation stage had a one-year cumulative stroke rate (including all cases of stroke or death within the 30-day perioperative period and all cases of ipsilateral stroke after this period) of 7.7% (95% CI: 4.8–10.6%) and a two-year cumulative stroke rate of 9.1% (95% CI: 5.8–12.4%). The Kaplan-Meier curves indicated significant differences according to the log-rank test (χ2 = 4.735, p = 0.030).


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)

Kaplan-Meier estimation of the cumulative stroke rate.The stroke incidences during the experience accumulation and technical maturation stages have been compared. The former stage yielded a one-year cumulative stroke rate (including all cases of stroke or death within the 30-day perioperative period and all cases of ipsilateral stroke after that period) of 15.7% (95% CI: 8.3–23.1%) and a two-year cumulative stroke rate of 18.8% (95% CI: 10.6–27.0%). The latter stage generated a one-year cumulative stroke rate (including all cases of stroke or death within the 30-day perioperative period and all cases of ipsilateral stroke after that period) of 7.7% (95% CI: 4.8–10.6%) and a two-year cumulative stroke rate of 9.1% (95% CI: 5.8–12.4%). The Kaplan-Meier plots differed significantly according to the log-rank test (X2 = 4.735, p = 0.030). Green curve: Experience accumulation stage. Blue curve: Technical maturation stage.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0139377.g003: Kaplan-Meier estimation of the cumulative stroke rate.The stroke incidences during the experience accumulation and technical maturation stages have been compared. The former stage yielded a one-year cumulative stroke rate (including all cases of stroke or death within the 30-day perioperative period and all cases of ipsilateral stroke after that period) of 15.7% (95% CI: 8.3–23.1%) and a two-year cumulative stroke rate of 18.8% (95% CI: 10.6–27.0%). The latter stage generated a one-year cumulative stroke rate (including all cases of stroke or death within the 30-day perioperative period and all cases of ipsilateral stroke after that period) of 7.7% (95% CI: 4.8–10.6%) and a two-year cumulative stroke rate of 9.1% (95% CI: 5.8–12.4%). The Kaplan-Meier plots differed significantly according to the log-rank test (X2 = 4.735, p = 0.030). Green curve: Experience accumulation stage. Blue curve: Technical maturation stage.
Mentions: The experience accumulation stage had a one-year cumulative stroke rate (including all cases of stroke or death within the 30-day perioperative period and all cases of ipsilateral stroke after this period) of 15.7% (95% CI: 8.3–23.1%) and a two-year cumulative stroke rate of 18.8% (95% CI: 10.6–27.0%) (Fig 3). In comparison, the technical maturation stage had a one-year cumulative stroke rate (including all cases of stroke or death within the 30-day perioperative period and all cases of ipsilateral stroke after this period) of 7.7% (95% CI: 4.8–10.6%) and a two-year cumulative stroke rate of 9.1% (95% CI: 5.8–12.4%). The Kaplan-Meier curves indicated significant differences according to the log-rank test (χ2 = 4.735, p = 0.030).

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