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Research ArticleInterventional

Symptom Differences and Pretreatment Asymptomatic Interval Affect Outcomes of Stenting for Intracranial Atherosclerotic Disease

M.D. Alexander, P.M. Meyers, J.D. English, T.R. Stradford, S. Sung, W.S Smith, V.V. Halbach, R.T. Higashida, C.F. Dowd, D.L. Cooke and S.W. Hetts
American Journal of Neuroradiology June 2014, 35 (6) 1157-1162; DOI: https://doi.org/10.3174/ajnr.A3836
M.D. Alexander
aFrom the Department of Radiology, Santa Clara Valley Medical Center, San Jose, California (M.D.A.)
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P.M. Meyers
bDepartments of Neurointerventional Surgery (P.M.M.)
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J.D. English
dDepartment of Neurology, California Pacific Medical Center, San Francisco, California (J.D.E.)
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T.R. Stradford
eDepartment of Medicine, St Luke's–Roosevelt Hospital, New York, New York (T.R.S.)
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S. Sung
cPathology (S.S.), Columbia University, New York, New York
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W.S Smith
fDepartments of Neurology (W.S.S.)
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V.V. Halbach
gRadiology and Biomedical Imaging (V.V.H., R.T.H., C.F.D., D.L.C., S.W.H.)hNeurological Surgery (V.V.H., R.T.H., C.F.D.), University of California, San Francisco, California.
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R.T. Higashida
gRadiology and Biomedical Imaging (V.V.H., R.T.H., C.F.D., D.L.C., S.W.H.)hNeurological Surgery (V.V.H., R.T.H., C.F.D.), University of California, San Francisco, California.
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C.F. Dowd
gRadiology and Biomedical Imaging (V.V.H., R.T.H., C.F.D., D.L.C., S.W.H.)hNeurological Surgery (V.V.H., R.T.H., C.F.D.), University of California, San Francisco, California.
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D.L. Cooke
gRadiology and Biomedical Imaging (V.V.H., R.T.H., C.F.D., D.L.C., S.W.H.)
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S.W. Hetts
gRadiology and Biomedical Imaging (V.V.H., R.T.H., C.F.D., D.L.C., S.W.H.)
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Article Figures & Data

Tables

    • View popup
    Table 1:

    Treatment characteristics

    No. of stents deployed
        06
        1136
        210
    Stent modalities
        Balloon-mounted, bare metal78
        Balloon-mounted, drug-eluting21
            Self-expanding47
            Total146
    Anesthesia technique
        MAC36
        GETA106
    Stent types
        AVE Series53
        Bx Velocity11
        Driver15
        Palmaz2
        Wingspan37
        Othera28
        Total146
    Stent-designed indications
        Coronary95
        Neuro40
        Peripheral11
        Total146
    Angiographic results
        MoriPretreatment stenosisPosttreatment stenosisSuccess
        A (n = 19)80.8%3.9%84.2%
        B (n = 73)80.2%7.8%89.0%
        C (n = 50)86.0%13.8%86.0%
    • Note:—MAC indicates monitors anesthesia care; GETA, general endotracheal anesthesia.

    • ↵a Cypher, Enterprise, Herculink, Multi-Link, Neuroform, NIR Primo, Precise, Sprint, Taxus.

    • View popup
    Table 2:

    Multivariate models

    OR95% CIP Value
    mRS >2 at last contact
        Tandem0.3190.143–0.713.005
        Hyperlipidemia3.1581.220–8.173.018
        Antiplatelet3.9071.107–13.792.034
        Tobacco0.4370.197–0.968.041
    Death at last contact
        Tandem0.2970.111–0.799.016
        Antiplatelet4.5041.017–19.949.047
        Diabetes0.4320.175–1.065.068
        PTA SES4.0280.875–18.532.074
        Tobacco0.4510.185–1.099.080
        Sex2.2850.649–8.042.198
        Neuro stent1.7250.393–7.565.470
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American Journal of Neuroradiology: 35 (6)
American Journal of Neuroradiology
Vol. 35, Issue 6
1 Jun 2014
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Symptom Differences and Pretreatment Asymptomatic Interval Affect Outcomes of Stenting for Intracranial Atherosclerotic Disease
M.D. Alexander, P.M. Meyers, J.D. English, T.R. Stradford, S. Sung, W.S Smith, V.V. Halbach, R.T. Higashida, C.F. Dowd, D.L. Cooke, S.W. Hetts
American Journal of Neuroradiology Jun 2014, 35 (6) 1157-1162; DOI: 10.3174/ajnr.A3836

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Symptom Differences and Pretreatment Asymptomatic Interval Affect Outcomes of Stenting for Intracranial Atherosclerotic Disease
M.D. Alexander, P.M. Meyers, J.D. English, T.R. Stradford, S. Sung, W.S Smith, V.V. Halbach, R.T. Higashida, C.F. Dowd, D.L. Cooke, S.W. Hetts
American Journal of Neuroradiology Jun 2014, 35 (6) 1157-1162; DOI: 10.3174/ajnr.A3836
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  • Lesion location, stability, and pretreatment management: factors affecting outcomes of endovascular treatment for vertebrobasilar atherosclerosis
    Matthew D Alexander, Jeffrey M Rebhun, Steven W Hetts, Anthony S Kim, Jeffrey Nelson, Helen Kim, Matthew R Amans, Fabio Settecase, Christopher F Dowd, Van V Halbach, Randall T Higashida, Daniel L Cooke
    Journal of NeuroInterventional Surgery 2016 8 5
  • Lesion stability characteristics outperform degree of stenosis in predicting outcomes following stenting for symptomatic intracranial atherosclerosis
    M D Alexander, D L Cooke, P M Meyers, M R Amans, C F Dowd, V V Halbach, R T Higashida, S W Hetts
    Journal of NeuroInterventional Surgery 2016 8 1
  • Stenting in Intracranial Stenosis: Current Controversies and Future Directions
    Arindam R. Chatterjee, Colin P. Derdeyn
    Current Atherosclerosis Reports 2015 17 8
  • Current Status and Future Perspective of Stenting for Symptomatic Intracranial Atherosclerotic Disease: A Meta-Analysis
    Zhong-Hao Li, Zhen-Hua Zhou, Xian-Jin Zhu, Wei Liu, Ya-Wen Chen, Zi-Yao Chen, Zun-Jing Liu
    BioMed Research International 2017 2017

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