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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Outcome of endovascular treatment in symptomatic intracranial vascular stenosis

Dae Chul Suh1, Sang Joon Kim, Duk Hee Lee

  • 1Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. dcsuh@www.amc.seoul.kr

Korean Journal of Radiology
|March 23, 2005
PubMed

Insights

This study shows that intracranial angioplasty and/or stenting for severe stenosis is highly successful, with a low rate of symptomatic recurrence. Physicians should remain aware of potential, though rare, fatal complications during these procedures.

Area of Science:

  • Neurology
  • Interventional Neuroradiology
  • Vascular Surgery

Background:

  • Revascularization of intracranial vascular stenoses is technically demanding, with limited outcome data.
  • Symptomatic severe intracranial stenosis poses a significant risk of cerebrovascular events.

Purpose of the Study:

  • To evaluate the early and late clinical outcomes of angioplasty and/or stenting for symptomatic severe intracranial vascular stenoses.
  • To assess angiographic success, periprocedural complications, and long-term recurrence rates.

Main Methods:

  • Retrospective analysis of 35 patients treated between 1995 and an unspecified end date.
  • Procedures included angioplasty (n=19) or stenting (n=16) for stenoses >70% in the middle cerebral artery, basilar artery, vertebral artery, and internal carotid artery.
  • Outcomes assessed included angiographic success (<50% residual stenosis), periprocedural complications (30-day), and symptomatic recurrence/restenosis (mean 22-month follow-up).

Main Results:

  • High angiographic success rate of 97% (34/35 patients).
  • Periprocedural complication rate of 11% (4/35 patients), including one death and one minor stroke.
  • Mean follow-up of 22 months showed asymptomatic restenosis in 9% and symptomatic restenosis in 6% of target lesions.

Conclusions:

  • Intracranial angioplasty and/or stenting achieves high angiographic success with an acceptable complication rate.
  • The procedure demonstrates a relatively low rate of symptomatic recurrence for intracranial vascular stenoses.
  • Physicians must be aware of the potential for rare but fatal periprocedural complications, such as hemorrhage.
Abstract

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