American Journal of Neuroradiology 26:869-874, April 2005
© 2005 American Society of Neuroradiology
INTERVENTIONAL
Stent-Assisted Angioplasty of Intracranial Vertebrobasilar Atherosclerosis: Midterm Analysis of Clinical and Radiologic Predictors of Neurological Morbidity and Mortality
a Section of Endovascular Neurosurgery, Department of Neurological Surgery, Cleveland Clinic Foundation, Cleveland, OH
b Department of Radiology, Cleveland Clinic Foundation, Cleveland, OH
Address correspondence to Peter Rasmussen, MD, Department of Neurological Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, S-80, Cleveland, OH 44195
BACKGROUND AND PURPOSE: Initial reports of stent-assisted angioplasty for intracranial vertebrobasilar atherosclerosis suggest this is a feasible treatment, but there have been little data regarding predictors of success or failure. We analyzed a series of patients for independent predictors of neurologic morbidity and mortality.
METHODS: Patient charts and angiograms from 39 patients who underwent intracranial angioplasty and stent placement of vertebrobasilar stenoses were retrospectively reviewed to obtain clinical and detailed angiographic data on potential predictors of neurologic morbidity and mortality. Univariate analyses of these predictors were performed with either Fisher’s exact test or simple logistic regression. Multivariate analysis was subsequently performed on the statistically significant predictors.
RESULTS: Complete clinical data were obtained for 39 patients, and angiographic review was possible for 35 of them. Angiography revealed severe intracranial vertebral (n = 18), basilar (n = 15), or basilar and vertebral (n = 2) stenoses. Two patients (5.1%) died in the periprocedural period, nine patients (23.1%) had neurologic complications, and one patient (2.6%) had transient neurologic symptoms. Univariate analysis revealed female sex, diabetes, and failure of coumadin or heparin therapy were associated with neurologic morbidity, whereas female sex, Mori B lesion, and length-to-stenosis ratio were associated with mortality. The presence of diabetes was the only independent predictor of neurologic morbidity and mortality.
CONCLUSION: Because of the limited number of patients available for analysis, the only independent predictor of neurologic morbidity and mortality was diabetes, but several other predictors showed trends that deserve further review in future series.
This article has been cited by other articles:
 |
|
 |
|
  K. Groschel, S. Schnaudigel, S. M. Pilgram, K. Wasser, and A. Kastrup A Systematic Review on Outcome After Stenting for Intracranial Atherosclerosis Stroke, May 1, 2009; 40(5): e340 - e347. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. C. Schumacher, P. M. Meyers, R. T. Higashida, C. P. Derdeyn, S. D. Lavine, G. M. Nesbit, D. Sacks, P. Rasmussen, and L. R. Wechsler Reporting Standards for Angioplasty and Stent-Assisted Angioplasty for Intracranial Atherosclerosis Stroke, May 1, 2009; 40(5): e348 - e365. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. H. Riedel, M. Tietke, K. Alfke, R. Stingele, and O. Jansen Subacute Stent Thrombosis in Intracranial Stenting Stroke, April 1, 2009; 40(4): 1310 - 1314. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. Puetz, G. Gahn, U. Becker, D. Mucha, A. Mueller, N.U. Weir, B. Wiedemann, and R. von Kummer Endovascular Therapy of Symptomatic Intracranial Stenosis in Patients With Impaired Regional Cerebral Blood Flow or Failure of Medical Therapy AJNR Am. J. Neuroradiol., February 1, 2008; 29(2): 273 - 280. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Fiorella and H. H. Woo Emerging Endovascular Therapies for Symptomatic Intracranial Atherosclerotic Disease Stroke, August 1, 2007; 38(8): 2391 - 2396. [Full Text] [PDF]
|
|
|
|
 |
|
 W. J. Jiang, X. T. Xu, B. Du, K. H. Dong, M. Jin, Q. H. Wang, and N. Ma Long-term outcome of elective stenting for symptomatic intracranial vertebrobasilar stenosis Neurology, March 13, 2007; 68(11): 856 - 858. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Fiorella, E. I. Levy, A. S. Turk, F. C. Albuquerque, D. B. Niemann, B. Aagaard-Kienitz, R. A. Hanel, H. Woo, P. A. Rasmussen, L. N. Hopkins, et al. US Multicenter Experience With the Wingspan Stent System for the Treatment of Intracranial Atheromatous Disease: Periprocedural Results Stroke, March 1, 2007; 38(3): 881 - 887. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. J. Jiang, T. Srivastava, F. Gao, B. Du, K. H. Dong, and X. T. Xu Perforator stroke after elective stenting of symptomatic intracranial stenosis Neurology, June 27, 2006; 66(12): 1868 - 1872. [Abstract] [Full Text] [PDF]
|
|