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AJNR - American Journal of Neuroradiology

Published ahead of print on February 29, 2008
doi: 10.3174/ajnr.A0922

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American Journal of Neuroradiology 29:781-785, April 2008
© 2008 American Society of Neuroradiology

INTERVENTIONAL

Intracranial Stenting of Severe Symptomatic Intracranial Stenosis: Results of 100 Consecutive Patients

D.C. Suh^a, J.K. Kim^d, J.W. Choi^a, B.S. Choi^a, H.W. Pyun^e, Y.J. Choi^a, M.-H. Kim^a, H.R. Yang^a, H.I. Ha^a, S.J. Kim^a, D.H. Lee^a, C.G. Choi^a, K.D. Hahm^c and J.S. Kim^b

^a Departments of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
^b Department of Neurology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
^c Departments of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
^d Department of Radiology, Seoul Veterans Hospital, Seoul, Korea
^e Department of Radiology, Inha University Hospital, Incheon, Korea

Please address correspondence to Dae Chul Suh, MD, PhD, Department of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, 388-one Pungnap-2 Dong, Songpa-Gu, Seoul, 138-736, Korea; e-mail: dcsuh{at}amc.seoul.kr

BACKGROUND AND PURPOSE: There are a few reports regarding the outcome evaluation of balloon-expandable intracranial stent placement (BEICS). The purpose of our study was to evaluate the outcome and factors related to the adverse events (AEs) of BEICS.

MATERIALS AND METHODS: We evaluated 100 consecutive patients who underwent BEICS. We assessed the procedural success (residual stenosis <50%), AEs (minor strokes, major strokes, and death), clinical outcome, and restenosis (>50%) at 6 months. We also analyzed 18 factors including symptom patterns related to AE rate. Symptom patterns revealed 1) stable patients (n = 73) with improving, stationary, or resolved symptoms; and 2) unstable patients (n = 27) with gradual worsening or fluctuating symptoms (National Institutes of Health Stroke Scale [NIHSS] 4) within 2 days before stent placement.

RESULTS: The procedural success rate was 99%. Overall, there were 10 (10%) AEs within the 6 months: 4 (4%) minor strokes, 3 (3%) major strokes, and 3 (3%) deaths including a death from myocardial infarction. AE rate was 4.1% in stable and 25.9% in unstable patients. Restenosis at 6 months revealed 0% (0/59). Good outcome (modified Rankin Scale 2) at 6 months was 97% (71/73) in stable and 67% (18/27) in unstable patients. Stepwise logistic regression model revealed that symptom pattern (unstable versus stable) was the only significant risk factor (OR, 8.167; 95% CI, 1.933–34.500; P = .004).

CONCLUSION: BEICS revealed a low AE and good outcome rate at 6 months, especially in the stable patients. Midterm outcome was also favorable in the unstable patient group.