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Research ArticleINTERVENTIONAL

Stent-Assisted Angioplasty of Intracranial Vertebrobasilar Atherosclerosis: Midterm Analysis of Clinical and Radiologic Predictors of Neurological Morbidity and Mortality

Michael M. Chow, Thomas J. Masaryk, Henry H. Woo, Marc R. Mayberg and Peter A. Rasmussen
American Journal of Neuroradiology April 2005, 26 (4) 869-874;
Michael M. Chow
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Thomas J. Masaryk
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Henry H. Woo
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Marc R. Mayberg
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Peter A. Rasmussen
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Abstract

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.

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American Journal of Neuroradiology: 26 (4)
American Journal of Neuroradiology
Vol. 26, Issue 4
1 Apr 2005
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Stent-Assisted Angioplasty of Intracranial Vertebrobasilar Atherosclerosis: Midterm Analysis of Clinical and Radiologic Predictors of Neurological Morbidity and Mortality
Michael M. Chow, Thomas J. Masaryk, Henry H. Woo, Marc R. Mayberg, Peter A. Rasmussen
American Journal of Neuroradiology Apr 2005, 26 (4) 869-874;

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Stent-Assisted Angioplasty of Intracranial Vertebrobasilar Atherosclerosis: Midterm Analysis of Clinical and Radiologic Predictors of Neurological Morbidity and Mortality
Michael M. Chow, Thomas J. Masaryk, Henry H. Woo, Marc R. Mayberg, Peter A. Rasmussen
American Journal of Neuroradiology Apr 2005, 26 (4) 869-874;
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  • Stenting for intracranial stenosis: potential future for the prevention of disabling or fatal stroke
  • Symptom Differences and Pretreatment Asymptomatic Interval Affect Outcomes of Stenting for Intracranial Atherosclerotic Disease
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  • Wingspan Stents for the Treatment of Symptomatic Atherosclerotic Stenosis in Small Intracranial Vessels: Safety and Efficacy Evaluation
  • Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
  • Reporting standards for angioplasty and stent-assisted angioplasty for intracranial atherosclerosis
  • A Systematic Review on Outcome After Stenting for Intracranial Atherosclerosis
  • Reporting Standards for Angioplasty and Stent-Assisted Angioplasty for Intracranial Atherosclerosis
  • Subacute Stent Thrombosis in Intracranial Stenting
  • Emerging Endovascular Therapies for Symptomatic Intracranial Atherosclerotic Disease
  • Long-term outcome of elective stenting for symptomatic intracranial vertebrobasilar stenosis
  • US Multicenter Experience With the Wingspan Stent System for the Treatment of Intracranial Atheromatous Disease: Periprocedural Results
  • Perforator stroke after elective stenting of symptomatic intracranial stenosis
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