Journal article
Safety and efficacy of balloon-mounted stent in the treatment of symptomatic intracranial atherosclerotic disease: a multicenter experience
Journal of neurointerventional surgery, Vol.14(8), pp.756-761
08/04/2021
DOI: 10.1136/neurintsurg-2021-017818
PMID: 34349013
Abstract
BackgroundRandomized clinical trials have failed to prove that the safety and efficacy of endovascular treatment for symptomatic intracranial atherosclerotic disease (ICAD) is better than that of medical management. A recent study using a self-expandable stent showed acceptable lower rates of periprocedural complications.ObjectiveTo study the safety and efficacy of a balloon-mounted stent (BMS) in the treatment of symptomatic ICAD.MethodsProspectively maintained databases from 15 neuroendovascular centers between 2010 and 2020 were reviewed. Patients were included if they had severe symptomatic intracranial stenosis in the target artery, medical management had failed, and they underwent intracranial stenting with BMS after 24 hours of the qualifying event. The primary outcome was the occurrence of stroke and mortality within 72 hours after the procedure. Secondary outcomes were the occurrence of stroke, transient ischemic attacks (TIAs), and mortality on long-term follow-up.ResultsA total of 232 patients were eligible for the analysis (mean age 62.8 years, 34.1% female). The intracranial stenotic lesions were located in the anterior circulation in 135 (58.2%) cases. Recurrent stroke was the qualifying event in 165 (71.1%) while recurrent TIA was identified in 67 (28.9%) cases. The median (IQR) time from the qualifying event to stenting was 5 (2–20.75) days. Strokes were reported in 13 (5.6%) patients within 72 hours of the procedure; 9 (3.9%) ischemic and 4 (1.7%) hemorrhagic, and mortality in 2 (0.9%) cases. Among 189 patients with median follow-up time 6 (3–14.5) months, 12 (6.3%) had TIA and 7 (3.7%) had strokes. Three patients (1.6%) died from causes not related to stroke.ConclusionOur study has shown that BMS may be a safe and effective treatment for medically refractory symptomatic ICAD. Additional prospective randomized clinical trials are warranted.
Details
- Title: Subtitle
- Safety and efficacy of balloon-mounted stent in the treatment of symptomatic intracranial atherosclerotic disease: a multicenter experience
- Creators
- Mahmoud H Mohammaden - Department of NeurologyRaul G Nogueira - Department of NeurologyWondwossen Tekle - Department of NeurologySantiago Ortega-Gutierrez - University of IowaMudassir Farooqui - University of Iowa Hospitals and ClinicsCynthia B. Zevallos - University of IowaRicardo A Hanel - Baptist Medical Center JacksonvilleGustavo M Cortez - Baptist Medical Center JacksonvilleAmin Aghaebrahim - Baptist Medical Center JacksonvilleRobert M Starke - University of MiamiHany Aref - Ain Shams University Faculty of MedicineAhmed Elbassiouny - Ain Shams University Faculty of MedicineAyman Gamea - South Valley UniversityAli Alaraj - University of Illinois at ChicagoMorteza Sadeh - University of Illinois at ChicagoMikayel Grigoryan - Adventist Health GlendaleOkkes Kuybu - Department of NeurologyDiogo C Haussen - Department of NeurologySunil A Sheth - The University of Texas Health Science Center at HoustonAlberto Maud - Texas Tech University Health Sciences Center at El PasoSteve M Cordina - University of South AlabamaOmar Tanweer - New York University Langone Medical CenterPeter Kan - Baylor Scott & White HealthJan-Karl Burkhardt - University of Pennsylvania Health SystemRamesh Grandhi - University of UtahFarhan Siddiq - University of Missouri SystemAmeer E Hassan - Department of Neurology
- Resource Type
- Journal article
- Publication Details
- Journal of neurointerventional surgery, Vol.14(8), pp.756-761
- DOI
- 10.1136/neurintsurg-2021-017818
- PMID
- 34349013
- NLM abbreviation
- J Neurointerv Surg
- ISSN
- 1759-8478
- eISSN
- 1759-8486
- Publisher
- BMJ Publishing Group Ltd
- Language
- English
- Date published
- 08/04/2021
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984302199502771
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