Related Experiment Video
Updated: May 30, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
How effective is endovascular intracranial revascularization in stroke prevention? Results from Borgess Medical
Insights
Angioplasty may reduce stroke risk after intracranial stenosis intervention compared to medical therapy. Stent placement methods did not show improved stroke prevention rates in this study.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Vascular Surgery
Background:
- Symptomatic intracranial atherosclerotic stenosis (70%-99%) carries an 18% risk of subsequent ischemic stroke within 1 year.
- The effectiveness of endovascular revascularization for stroke prevention in these patients remains unclear.
- Previous studies have compared stent placement and angioplasty outcomes.
Purpose of the Study:
- To compare the 1-year stroke rate following endovascular revascularization with historical data from the WASID study.
- To identify which endovascular revascularization method offers the most benefit in stroke prevention for intracranial stenosis.
Main Methods:
- A single-center, single-operator registry of consecutive symptomatic patients undergoing endovascular intracranial revascularization was maintained.
- Patients were treated with angioplasty, balloon-mounted stents (BMS), or self-expandingWireless stents (WS).
- Data from patients with a single lesion (50%-99% stenosis) undergoing a single intervention were analyzed retrospectively, comparing outcomes to the WASID study.
Main Results:
- The study included 115 patients: 38 angioplasty, 28 BMS, and 49 WS.
- The overall 1-year stroke probability for patients with 70%-99% stenosis was 19.3%.
- Stroke probabilities per device were 12.5% for angioplasty, 20.2% for BMS, and 24.1% for WS.
Conclusions:
- Angioplasty demonstrated a lower 1-year stroke rate compared to medical therapy alone, based on WASID data.
- Neither BMS nor WS placement showed a favorable comparison with WASID results regarding stroke prevention.
- Further research is needed to establish optimal endovascular strategies for intracranial stenosis.
Background And Purpose:
The WASID study established the risk of subsequent ischemic stroke at 1 year in subjects with symptomatic intracranial atherosclerotic stenosis (70%-99%) at 18%. The efficacy of different methods of endovascular revascularization in stroke prevention still has not been established. We compared the stroke rate in our registry at 1 year following intervention with the WASID results to identify which method, if any, provides the most benefit in stroke prevention. This result from the BMC-IRR follows a previously published article comparing stent placement and angioplasty outcomes.
Materials And Methods:
We maintained a nonrandomized single-center single-operator registry of consecutive symptomatic patients who underwent endovascular intracranial revascularization. Data were collected prospectively and retrospectively and analyzed retrospectively. Patients were treated with angioplasty, BMS, or self-expanding WS. To make our data comparable with that in the WASID study, we selected patients with a single lesion of 50%-99% stenosis undergoing a single intervention. Data was collected on patients until symptom recurrence, repeat intervention, or 1 year postintervention, whichever occurred first.
Results:
We found that 115 patients fit the inclusion criteria, with 38 angioplasty, 28 BMS, and 49 WS cases. For patients with 70%-99% stenosis, the overall probability of stroke at 1 year postintervention was 19.3%. The overall stroke probability per device, independent of clinical presentation, was 12.5% for angioplasty, 20.2% for BMS, and 24.1% for WS.
Conclusions:
Compared with the WASID data, angioplasty appears to have a lower stroke rate after 1 year than medical therapy alone. However, neither stent-placement arm compared favorably with the WASID results.