title: Clinical and angiographic results of dilatation procedures for symptomatic intracranial atherosclerotic disease.
abstract: OBJECTIVE
  The authors determined the technical success and the clinical and angiographic results of angioplasty and/or stent placement for intracranial atherosclerotic disease (ICAD) at a tertiary-care referral hospital.
  
  
  METHODS
  Angiographic and clinical outcomes occurring within the 1-month follow-up interval were recorded. Patients were followed up for a mean period of 20.5 +/- 9.2 months, and a neurovascular imaging study was performed in 18 of the 21 patients alive after a mean period of 19.7 +/- 9.2 months. Stroke-free survival and ipsilateral stroke-prevention rates were estimated using Kaplan Meier analyses.
  
  
  RESULTS
  Twenty-four patients (mean age = 61.0 +/- 13.5 years; 15 were men) underwent 30 procedures for treatment of ICAD. The procedures included angioplasty (n = 18) and attempted primary stent placement (n = 14). In 2 procedures, angioplasty was performed in the same session after unsuccessful stent placement. There was immediate stenosis reduction (mean +/- SD) from 84% +/- 17% to 27% +/- 21%. The overall 1-month composite rate of major stroke, death, and major bleeding complications was 7% for the 30 procedures. Overall stroke-free survival at 36 months was estimated as 79% (95% confidence interval, 57%-91%), and the ipsilateral stroke-prevention rate was estimated to be 87% (95% confidence interval, 65%-95%). Among the 15 patients who underwent repeat angiography, restenosis requiring second intervention was observed in 1 patient. No restenosis could be identified in 3 patients who underwent computed tomographic or magnetic resonance angiography.
  
  
  CONCLUSIONS
  This single-center study demonstrates the feasibility and effectiveness (for secondary stroke prevention) of angioplasty and/or stent placement for treatment of ICAD.
authors.affiliation: Department of Neurosurgery and Toshiba Stroke Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, USA. aiqureshi@hotmail.com
authors.forename: Adnan I
authors.initials: AI
authors.lastname: Qureshi
authors.forename: M Fareed K
authors.initials: MF
authors.lastname: Suri
authors.forename: Amir M
authors.initials: AM
authors.lastname: Siddiqui
authors.forename: Stanley H
authors.initials: SH
authors.lastname: Kim
authors.forename: Alan S
authors.initials: AS
authors.lastname: Boulos
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Ringer
authors.forename: Demetrius K
authors.initials: DK
authors.lastname: Lopes
authors.forename: Lee R
authors.initials: LR
authors.lastname: Guterman
authors.forename: L Nelson
authors.initials: LN
authors.lastname: Hopkins
mesh_terms: D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon; D002533:Cerebral Angiography; D004106:Dilatation; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015607:Stents; D020521:Stroke / Q000517:prevention & control; D013997:Time Factors