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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Elective percutaneous intervention for intracranial atherosclerotic stenoses by interventional cardiologists

Ramy A Badawi1, Christopher J White, Tyrone J Collins

  • 1Department of Cardiovascular Diseases, The John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, Louisiana 70121, USA. rbadawi@msn.com

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|November 29, 2011
PubMed

Insights

Catheter-based therapy (CBT) for symptomatic intracranial atherosclerotic disease offers high success and good outcomes. This treatment is a safe option for high-risk patients who have not responded to medical therapy.

Area of Science:

  • Cardiology
  • Neurology
  • Interventional Radiology

Background:

  • Symptomatic atherosclerotic intracranial disease carries a high risk of recurrence despite optimal medical therapy.
  • Catheter-based therapy (CBT) presents an alternative for patients unresponsive to medical management.
  • This study evaluates CBT outcomes in patients with intracranial arterial disease.

Purpose of the Study:

  • To assess the safety and efficacy of catheter-based therapy (CBT) for symptomatic intracranial arterial disease.
  • To examine the procedural success and clinical outcomes of CBT in a high-risk patient cohort.
  • To compare CBT outcomes against the expected recurrence rates of medical therapy.

Main Methods:

  • Retrospective analysis of 89 consecutive patients with 99 significant (≥70% diameter) intracranial arterial stenoses.
  • CBT performed by experienced interventional cardiologists with neurovascular team support.
  • Primary endpoint: stroke and vascular death; secondary endpoints included procedural success and mortality.

Main Results:

  • High procedural success rate of 97% (96/99 lesions).
  • Significant reduction in diameter stenosis from 91% to 19% (P < 0.001).
  • 1-year stroke and vascular death rate of 5.7%; 2-year rate of 13.5%. In-hospital stroke/death rate was 3%.

Conclusions:

  • CBT is safe and effective for symptomatic intracranial arterial stenosis in patients who failed medical therapy.
  • High procedural success and excellent 1-year clinical outcomes were observed.
  • CBT is an attractive option for high-risk patients, offering an alternative to high recurrence rates with medical therapy.
Abstract

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