PT  - JOURNAL ARTICLE
AU  - J.C. Wojak
AU  - D.C. Dunlap
AU  - K.R. Hargrave
AU  - L.A. DeAlvare
AU  - H.S. Culbertson
AU  - J.J. Connors III
TI  - Intracranial Angioplasty and Stenting: Long-Term Results from a Single Center
DP  - 2006 Oct 01
TA  - American Journal of Neuroradiology
PG  - 1882--1892
VI  - 27
IP  - 9
4099  - http://www.ajnr.org/content/27/9/1882.short
4100  - http://www.ajnr.org/content/27/9/1882.full
SO  - Am. J. Neuroradiol.2006 Oct 01; 27
AB  - BACKGROUND AND PURPOSE: Large-vessel intracranial atherosclerotic stenosis carries a proved stroke risk of 8%–22% per year with “best medical therapy.” The long-term clinical neurologic and angiographic outcomes of angioplasty and/or stent placement for intracranial atherosclerosis in a consecutive series of patients are presented.METHODS: The demographics, procedural details, procedural outcome, and long-term neurologic follow-up in 60 consecutive patients with 71 lesions, undergoing a total of 84 procedures, were analyzed.RESULTS: Angioplasty alone was performed in 62 procedures; 22 procedures involved stent placement. The periprocedural stroke+death rate was 4.8%. The overall complication-free success rate was 90.5%. Restenosis occurred in 23 lesions at a mean of 4.6 months; 13 were re-treated without complication. There were 4 strokes and 4 non-neurologic deaths during 224 patient-years of follow-up. The annualized stroke rate was 1.8%, and the annualized stroke+all-cause death rate was 3.0%.CONCLUSIONS: The stroke and death rates in this consecutive series of patients with severe intracranial atherosclerotic stenosis treated with optimal endovascular therapy are considerably less than those associated with the natural history of intracranial atherosclerosis treated with maximal medical therapy. Intracranial angioplasty with conditional stent placement is technically feasible and clinically effective with a substantial reduction in long-term stroke and death.