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Angioplasty and Stenting of Atherosclerotic Middle Cerebral Arteries with Wingspan: Evaluation of Clinical Outcome, Restenosis, and Procedure Outcome

Angioplasty and Stenting of Atherosclerotic Middle Cerebral Arteries with Wingspan: Evaluation of... This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A2363v1 32/4/753 most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Yu, S. C. H. Articles by Wong, L. K. S. PubMed PubMed Citation Articles by Yu, S. C. H. Articles by Wong, L. K. S. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 32:753-758, April 2011 © 2011 American Society of Neuroradiology INTERVENTIONAL Angioplasty and Stenting of Atherosclerotic Middle Cerebral Arteries with Wingspan: Evaluation of Clinical Outcome, Restenosis, and Procedure Outcome S.C.H. Yu a , T.W.H. Leung b , K.T. Lee a , J.W.Y. Hui a and L.K.S. Wong b a From the Departments of Imaging and Interventional Radiology (S.C.H.Y., K.T.L., J.W.Y.H.) b Medicine and Therapeutics (T.W.H.L., L.K.S.W.), Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China. Please address correspondence to Simon Chun Ho Yu, MD, Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, The Chinese University of Hong Kong, 30–32 Ngan Shing St, Shatin, Hong Kong, China; e-mail: simonyu@cuhk.edu.hk BACKGROUND AND PURPOSE: MCA is a common location of intracranial stenosis. It is relatively more peripherally located and of a smaller caliber, and could therefore be a site technically more challenging and risky for angioplasty and stenting. The study aimed to evaluate the clinical outcome, restenosis rate, and procedural safety of Wingspan stent placement for atherosclerosis in the MCA compared with stenosis in other arteries. MATERIALS AND METHODS: Patients who underwent Wingspan stent placement for symptomatic intracranial stenosis of 70% (or stenosis of 50% for recurrent ischemia despite medical therapy) were recruited prospectively and allocated into a study group (MCA stenosis, n = 35) and a control group (other stenosis, n = 25). Primary end points were the following: 1) all stroke or death rate at 1 year, and 2) significant in-stent restenosis rate at 1 year. Secondary end points were the following: 1) periprocedural complications within 24 hours, rate of TIA during the procedure, all stroke or death rate within 30 days; and 2) the inability to complete the procedure due to technical problems. RESULTS: Results of study group versus the control group were the following: degree of stenosis, 78.4 ± 10.9% versus 72.5 ± 11.2% ( P value = .0456); diameter of stenosis, 0.6 ± 0.3 versus 1.0 ± 0.5 mm ( P = .0017); all stroke or death rate at 1 year, 14.3% versus 12% (OR = 1.22); in-stent restenosis rate at 1 year, 10% versus 10.5% (OR = 1.05); periprocedural complication rate at 24 hours, 2.9% versus 4% (OR = 0.70); TIA rate during the procedure, 8.6% versus 4% (OR = 2.25); all stroke or death rate at 30 days, 5.7% versus 12% (OR = 0.44); and technical failure rate, 2.9% versus 0%. CONCLUSIONS: In this study, there were no significant differences in procedural safety, patient outcome, and restenosis rates of stent placement between the group with MCA stenosis and the group with stenoses located at other sites. Abbreviations: CI, confidence interval • 3DRA, 3D rotational angiography • DSA, digital-subtraction angiography • MCA, middle cerebral artery • nFU , number of patients with follow-up DSA performed • OR, odds ratio • TIA, transient ischemic attack • WASID, Warfarin Aspirin Symptomatic Intracranial Disease Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2011 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Angioplasty and Stenting of Atherosclerotic Middle Cerebral Arteries with Wingspan: Evaluation of Clinical Outcome, Restenosis, and Procedure Outcome

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Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2011 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A2363
Publisher site
See Article on Publisher Site

Abstract

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A2363v1 32/4/753 most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Yu, S. C. H. Articles by Wong, L. K. S. PubMed PubMed Citation Articles by Yu, S. C. H. Articles by Wong, L. K. S. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 32:753-758, April 2011 © 2011 American Society of Neuroradiology INTERVENTIONAL Angioplasty and Stenting of Atherosclerotic Middle Cerebral Arteries with Wingspan: Evaluation of Clinical Outcome, Restenosis, and Procedure Outcome S.C.H. Yu a , T.W.H. Leung b , K.T. Lee a , J.W.Y. Hui a and L.K.S. Wong b a From the Departments of Imaging and Interventional Radiology (S.C.H.Y., K.T.L., J.W.Y.H.) b Medicine and Therapeutics (T.W.H.L., L.K.S.W.), Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China. Please address correspondence to Simon Chun Ho Yu, MD, Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, The Chinese University of Hong Kong, 30–32 Ngan Shing St, Shatin, Hong Kong, China; e-mail: simonyu@cuhk.edu.hk BACKGROUND AND PURPOSE: MCA is a common location of intracranial stenosis. It is relatively more peripherally located and of a smaller caliber, and could therefore be a site technically more challenging and risky for angioplasty and stenting. The study aimed to evaluate the clinical outcome, restenosis rate, and procedural safety of Wingspan stent placement for atherosclerosis in the MCA compared with stenosis in other arteries. MATERIALS AND METHODS: Patients who underwent Wingspan stent placement for symptomatic intracranial stenosis of 70% (or stenosis of 50% for recurrent ischemia despite medical therapy) were recruited prospectively and allocated into a study group (MCA stenosis, n = 35) and a control group (other stenosis, n = 25). Primary end points were the following: 1) all stroke or death rate at 1 year, and 2) significant in-stent restenosis rate at 1 year. Secondary end points were the following: 1) periprocedural complications within 24 hours, rate of TIA during the procedure, all stroke or death rate within 30 days; and 2) the inability to complete the procedure due to technical problems. RESULTS: Results of study group versus the control group were the following: degree of stenosis, 78.4 ± 10.9% versus 72.5 ± 11.2% ( P value = .0456); diameter of stenosis, 0.6 ± 0.3 versus 1.0 ± 0.5 mm ( P = .0017); all stroke or death rate at 1 year, 14.3% versus 12% (OR = 1.22); in-stent restenosis rate at 1 year, 10% versus 10.5% (OR = 1.05); periprocedural complication rate at 24 hours, 2.9% versus 4% (OR = 0.70); TIA rate during the procedure, 8.6% versus 4% (OR = 2.25); all stroke or death rate at 30 days, 5.7% versus 12% (OR = 0.44); and technical failure rate, 2.9% versus 0%. CONCLUSIONS: In this study, there were no significant differences in procedural safety, patient outcome, and restenosis rates of stent placement between the group with MCA stenosis and the group with stenoses located at other sites. Abbreviations: CI, confidence interval • 3DRA, 3D rotational angiography • DSA, digital-subtraction angiography • MCA, middle cerebral artery • nFU , number of patients with follow-up DSA performed • OR, odds ratio • TIA, transient ischemic attack • WASID, Warfarin Aspirin Symptomatic Intracranial Disease Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2011 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Apr 1, 2011

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