Faculty Collaboration Database

Balloon angioplasty for intracranial atherosclerotic disease: periprocedural risks and short-term outcomes in a multicenter study. Stroke 2011 Jan;42(1):107-11

Date

11/13/2010

Pubmed ID

21071722

DOI

10.1161/STROKEAHA.110.583245

Scopus ID

2-s2.0-79451475119 (requires institutional sign-in at Scopus site)   60 Citations

Abstract

BACKGROUND AND PURPOSE: whether stenting is superior to angioplasty in the treatment of intracranial atherosclerotic disease is unknown. Dissections, vessel rupture, and lesion recoil observed with primary angioplasty using balloon catheters designed for coronary arteries have undermined the role of primary angioplasty as a preferred treatment for intracranial atherosclerotic disease. The goal of this study is to report the immediate and 3-month outcomes of treating patients with intracranial atherosclerotic disease with angioplasty balloon catheters in a multicenter study.

METHODS: this is a retrospective review of 74 patients from 4 institutions treated with primary angioplasty for intracranial atherosclerotic disease over a 6-year time period. Technical success (residual stenosis ≤ 50%), periprocedural success (no vascular complication within 72 hours), and 3-month outcomes are reported.

RESULTS: the mean degree of stenosis pretreatment was 79% ± 14% and reduced to 34% ± 18% after angioplasty. Technical success was achieved in 68 (92%; 95% CI, 83% to 97%) of the 74 patients. Periprocedural success was achieved in 65 (88%; 95% CI, 78% to 94%) of the 74 patients. There were 4 (5%; 95% CI, 1.5% to 13%) major procedure-related strokes, 2 of which resulted in death within 6 hours of the procedure. The 30-day stroke/death rate was 5% (4 of 74; CI, 1.5% to 13%). Three-month follow-up was available in 71 patients. In this interval, 2 patients had new stroke, 1 in the ipsilateral territory and the other in the contralateral territory. The 3-month stroke or death rate was 8.5% (6 of 71; CI, 3.1% to 17.5%); the retreatment rate was 2.8% (2 of 71; CI, 0.3% to 10%).

CONCLUSIONS: balloon angioplasty is a relatively safe alternative treatment for intracranial atherosclerotic disease. Its role in the long-term secondary prevention of recurrent stroke as compared with intracranial stenting and medical therapy remains to be determined, preferably in a randomized study.

Author List

Nguyen TN, Zaidat OO, Gupta R, Nogueira RG, Tariq N, Kalia JS, Norbash AM, Qureshi AI

MESH terms used to index this publication - Major topics in bold

Aged
Angioplasty, Balloon
Female
Follow-Up Studies
Humans
Intracranial Arteriosclerosis
Male
Middle Aged
Retrospective Studies
Stroke
Time Factors