More articles from INTERVENTIONAL
- Primary Angioplasty without Stenting for Symptomatic, High-Grade Intracranial Stenosis with Poor Circulation
Thirty-five patients with high-grade, symptomatic intracranial stenosis and poor antegrade flow, treated with intracranial angioplasty without stent placement from January 2010 to December 2016, were retrospectively reviewed. The main outcomes included the changes in antegrade flow and residual stenosis and any stroke or death within 1 month. The average preprocedure stenosis was 88%. The immediate, average postprocedure stenosis rate was 25%, and the average postprocedure stenosis rate at last angiographic follow-up was 35%. The primary end point of major stroke or death at 30 days was observed in 1 patient (1/35, 2.9%), and no patient had intraprocedural complications. The authors conclude that primary balloon angioplasty was an effective treatment option for symptomatic intracranial stenosis with a high risk of stroke.
- Clinical Significance of Intraplaque Hemorrhage in Low- and High-Grade Basilar Artery Stenosis on High-Resolution MRI
Patients with basilar artery stenosis (n=126; 66 symptomatic and 60 asymptomatic) underwent high-resolution MR imaging. The relationship between imaging findings (intraplaque hemorrhage, contrast enhancement, degree of stenosis, minimal lumen area, and plaque burden) and symptoms was analyzed. Intraplaque hemorrhage was identified in 22 patients (17.5%), including 21 (31.8%) symptomatic patients and 1 (1.7%) asymptomatic patient. Multivariate analysis showed that intraplaque hemorrhage was the strongest independent marker of symptomatic status. Contrast enhancement was also independently associated with symptomatic status. The authors conclude that intraplaque hemorrhage is present in both low- and high-grade stenotic basilar artery plaques and is independently associated with symptomatic stroke status. Intraplaque hemorrhage may identify high-risk plaque and provide new insight into the management of patients with stroke without significant stenosis.