Journal article
Nonprocedural Symptomatic Infarction and In-Stent Restenosis After Intracranial Angioplasty and Stenting in the SAMMPRIS Trial (Stenting and Aggressive Medical Management for the Prevention of Recurrent Stroke in Intracranial Stenosis)
Stroke (1970), Vol.48(6), pp.1501-1506
06/2017
DOI: 10.1161/STROKEAHA.116.014537
PMCID: PMC8204379
PMID: 28455321
Abstract
The purpose of this study was to investigate the frequency of symptomatic in-stent restenosis (ISR) and its contribution to nonprocedural symptomatic infarction in the SAMMPRIS trial (Stenting and Aggressive Medical Management for the Prevention of Recurrent Stroke in Intracranial Stenosis).
Patients without a periprocedural primary end point were followed up to determine the occurrence of any of the following events: ischemic stroke, cerebral infarct with temporary signs, or transient ischemic attack in the territory of the stented artery. Vascular imaging performed after these events was reviewed for ISR. Annual rates for symptomatic ISR were calculated using Kaplan-Meier estimates.
Of 183 patients in the stenting group without a periprocedural primary end point, 27 (14.8%) had a symptomatic infarction (stroke or cerebral infarct with temporary signs) and 16 (8.7%) had transient ischemic attack alone in the territory during a median follow-up of 35.0 months. Of the 27 patients with infarctions, 17 (9.3%) had an ischemic stroke and 10 (5.5%) had a cerebral infarct with temporary signs alone. Adequate vascular imaging to evaluate ISR was available in 24 patients with infarctions (showing ISR in 16 [66.7%]) and in 10 patients with transient ischemic attack alone (showing ISR in 8 [80%]). The 1-, 2-, and 3-year rates (with 95% confidence limits) for symptomatic ISR in the SAMMPRIS stent cohort were 9.6% (6.1%-14.9%), 11.3% (7.5%-17.0%), and 14.0% (9.6%-20.2%), respectively.
Symptomatic ISR occurred in at least 1 of 7 patients in SAMMPRIS by 3 years of follow-up and was likely responsible for the majority of nonprocedural cerebral infarctions.
URL: https://clinicaltrials.gov. Unique identifier: NCT00576693.
Details
- Title: Subtitle
- Nonprocedural Symptomatic Infarction and In-Stent Restenosis After Intracranial Angioplasty and Stenting in the SAMMPRIS Trial (Stenting and Aggressive Medical Management for the Prevention of Recurrent Stroke in Intracranial Stenosis)
- Creators
- Colin P Derdeyn - From the Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, State University of New York, Stony Brook (D.F.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, GA (M.J.L., G.A.C., B.F.L., J.M.); Department of Neurology, Medical University of South Carolina, Charleston (T.N.T., M.I.C.); and National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD (L.S.J.). colin-derdeyn@uiowa.eduDavid Fiorella - From the Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, State University of New York, Stony Brook (D.F.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, GA (M.J.L., G.A.C., B.F.L., J.M.); Department of Neurology, Medical University of South Carolina, Charleston (T.N.T., M.I.C.); and National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD (L.S.J.)Michael J Lynn - From the Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, State University of New York, Stony Brook (D.F.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, GA (M.J.L., G.A.C., B.F.L., J.M.); Department of Neurology, Medical University of South Carolina, Charleston (T.N.T., M.I.C.); and National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD (L.S.J.)Tanya N Turan - From the Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, State University of New York, Stony Brook (D.F.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, GA (M.J.L., G.A.C., B.F.L., J.M.); Department of Neurology, Medical University of South Carolina, Charleston (T.N.T., M.I.C.); and National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD (L.S.J.)George A Cotsonis - From the Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, State University of New York, Stony Brook (D.F.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, GA (M.J.L., G.A.C., B.F.L., J.M.); Department of Neurology, Medical University of South Carolina, Charleston (T.N.T., M.I.C.); and National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD (L.S.J.)Bethany F Lane - From the Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, State University of New York, Stony Brook (D.F.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, GA (M.J.L., G.A.C., B.F.L., J.M.); Department of Neurology, Medical University of South Carolina, Charleston (T.N.T., M.I.C.); and National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD (L.S.J.)Jean Montgomery - From the Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, State University of New York, Stony Brook (D.F.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, GA (M.J.L., G.A.C., B.F.L., J.M.); Department of Neurology, Medical University of South Carolina, Charleston (T.N.T., M.I.C.); and National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD (L.S.J.)L Scott Janis - From the Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, State University of New York, Stony Brook (D.F.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, GA (M.J.L., G.A.C., B.F.L., J.M.); Department of Neurology, Medical University of South Carolina, Charleston (T.N.T., M.I.C.); and National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD (L.S.J.)Marc I Chimowitz - From the Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, State University of New York, Stony Brook (D.F.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, GA (M.J.L., G.A.C., B.F.L., J.M.); Department of Neurology, Medical University of South Carolina, Charleston (T.N.T., M.I.C.); and National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD (L.S.J.)
- Resource Type
- Journal article
- Publication Details
- Stroke (1970), Vol.48(6), pp.1501-1506
- Publisher
- United States
- DOI
- 10.1161/STROKEAHA.116.014537
- PMID
- 28455321
- PMCID
- PMC8204379
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Grant note
- U01 NS058728 / NINDS NIH HHS
- Language
- English
- Date published
- 06/2017
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984020787602771
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