Intracranial angioplasty without stenting for symptomatic atherosclerotic stenosis: long-term follow-up.
OBJECTIVE
Angioplasty and stent placement have been reported for the treatment of intracranial stenosis. This study was undertaken to assess the efficacy and long-term clinical outcome of angioplasty without stent placement for patients with symptomatic intracranial stenosis.


METHODS
A retrospective study was done to evaluate 36 patients with 37 symptomatic atherosclerotic intracranial stenosis who underwent primary balloon angioplasty. All patients had symptoms despite medical therapy. Thirty-four patients were available for follow-up ranging from 6 to 128 months. Mean follow-up was 52.9 months.


RESULTS
Mean pretreatment stenosis was 84.2% before angioplasty and 43.3% after angioplasty. The periprocedural death and stroke rate was 8.3% (two deaths and one minor stroke). Two patients had strokes in the territory of angioplasty at 2 and 37 months after angioplasty. The annual stroke rate in the territory appropriate to the site of angioplasty was 3.36%, and for those patients with a residual stenosis of > or =50% it was 4.5%. Patients with iatrogenic dissection (n=11) did not have transient ischemic attacks or strokes after treatment.


CONCLUSIONS
Results of long-term follow-up suggest that intracranial angioplasty without stent placement reduces the risk of further stroke in symptomatic patients.
Marks
Michael P
MP
Department of Radiology, Stanford University Medical Center, Stanford, CA 94305, USA.
Marcellus
Mary L
ML
Do
Huy M
HM
Schraedley-Desmond
Pamela K
PK
Steinberg
Gary K
GK
Tong
David C
DC
Albers
Gregory W
GW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000453:epidemiology / Q000209:etiology; D000800:Angioplasty, Balloon / Q000009:adverse effects; D002533:Cerebral Angiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology; D015994:Incidence; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000453:epidemiology; D016896:Treatment Outcome