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Outcome of symptomatic intracranial atherosclerotic disease

Edgar A Samaniego1, Scott Hetzel, Supriya Thirunarayanan

  • 1Department of Neurology, University of Wisconsin-Madison, Madison, Wisc, USA. esamanie@stanford.edu

Stroke
|June 27, 2009
PubMed

Insights

Medical therapy and percutaneous transluminal angioplasty and stenting (PTAS) showed similar outcomes for patients with symptomatic intracranial atherosclerotic disease. Both treatments resulted in comparable rates of stroke, transient ischemic attack, and vascular death.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Interventional Cardiology

Background:

  • Intracranial atherosclerotic disease carries a significant annual stroke risk (3.6%-22%).
  • Evaluating treatment efficacy for symptomatic intracranial atherosclerotic disease is crucial for patient prognosis.

Purpose of the Study:

  • To compare the natural history and prognosis of symptomatic intracranial atherosclerotic disease treated with medical therapy versus percutaneous transluminal angioplasty and stenting (PTAS).

Main Methods:

  • Retrospective chart review of patients with symptomatic intracranial atherosclerotic disease (July 2004-September 2007).
  • Patients were categorized into 'best medical therapy' or PTAS plus antiplatelet agents groups.
  • Favorable outcome defined by absence of stroke, TIA, vascular death, mRS ≤3, and no reintervention for in-stent restenosis.

Main Results:

  • 111 patients were analyzed: 58 in Medical Therapy Group and 53 in PTAS Group.
  • Favorable outcomes were observed in 65.5% of the Medical Therapy Group and 69.8% of the PTAS Group.
  • Combined ischemic endpoints (TIA, stroke, vascular death) were similar: 24% in Medical Therapy vs. 28.3% in PTAS.

Conclusions:

  • The combined ischemic endpoint was statistically similar between the medical therapy and PTAS groups.
  • This suggests comparable efficacy for both treatment strategies in managing symptomatic intracranial atherosclerotic disease.
Abstract

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