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Adjuvant revascularization of intracranial artery occlusion with angioplasty and/or stenting

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

In conjunction with intravenous and/or intra-arterial thrombolysis, adjuvant revascularization of intracranial artery occlusion by angioplasty vs. stenting remains controversial. We evaluated outcome in patients with intracranial occlusion after angioplasty and/or stenting.

Materials and methods

Thirty-three patients who underwent angioplasty or stenting (17 stenting and 16 angioplasty) for intracranial arterial occlusion during the past 5 years were enrolled from prospective neurointerventional database. We compared recanalization rate [defined as thrombolysis in myocardial infarction (TIMI) grade II/III flow], adverse events, and clinical outcome [modified Rankin scale (mRS) at 1 and 6 months]. We also tried to determine independent variables associated with clinical outcome.

Results

Median initial National Institutes of Health Stroke Scale (NIHSS) was 13 and median time to treatment was 12 h from symptom onset. The successful recanalization rate was mean 79%. Symptomatic hemorrhage occurred in 15% (5/33). Events (27%, 9/33) at 1 month included four deaths, four major, and one minor stroke. Good outcome (mRS ≤ 2) was achieved in 17 patients (52%) at 6 months and was significantly related to age, initial NIHSS, TIMI flow, and stenting on bivariate analysis. On multivariable analysis, stenting was the only variable significantly associated with a 6-month, good clinical outcome (OR, 14.48; 95% CI, 1.76 to 118.93; p = 0.013)

Conclusion

Intracranial revascularization with angioplasty and/or stenting may improve the clinical outcome in selected patients with intracranial occlusion. Multiple factors are related to favorable clinical outcome.

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Acknowledgments

We acknowledge Sun Moon Whang, B.S. and Eun Hye Kim, R.N. in the patient data collection and the assistance of Eun Ja Yoon in manuscript preparation, and we thank Bonnie Hami, M.A. This study was supported by a grant of the Korea Healthcare technology R&D Project, Ministry of Health & Welfare, Republic of Korea (A080201).

Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-2dong, Songpa-Gu, Seoul, 138-736, Korea

    Jin Woo Choi, Byung Se Choi, Jeoung Hyun Kim, Hae Jun Hwang, Sang Joon Kim & Dae Chul Suh

  2. Department of Radiology, Seoul Veterans Hospital, 6-2 Doonchen-dong, Gangdong-gu, Seoul, 134-791, Korea

    Jae Kyun Kim

  3. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-2dong, Songpa-Gu, Seoul, 138-736, Korea

    Jong Sung Kim

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  1. Jin Woo Choi
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Correspondence to Dae Chul Suh.

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Choi, J.W., Kim, J.K., Choi, B.S. et al. Adjuvant revascularization of intracranial artery occlusion with angioplasty and/or stenting. Neuroradiology 51, 33–43 (2009). https://doi.org/10.1007/s00234-008-0462-y

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  • DOI: https://doi.org/10.1007/s00234-008-0462-y

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