Intracranial stenting of severe symptomatic intracranial stenosis: results of 100 consecutive patients.
OBJECTIVE
There are a few reports regarding the outcome evaluation of balloon-expandable intracranial stent placement (BEICS). The purpose of our study was to evaluate the outcome and factors related to the adverse events (AEs) of BEICS.


METHODS
We evaluated 100 consecutive patients who underwent BEICS. We assessed the procedural success (residual stenosis < 50%), AEs (minor strokes, major strokes, and death), clinical outcome, and restenosis (> 50%) at 6 months. We also analyzed 18 factors including symptom patterns related to AE rate. Symptom patterns revealed 1) stable patients (n = 73) with improving, stationary, or resolved symptoms; and 2) unstable patients (n = 27) with gradual worsening or fluctuating symptoms (National Institutes of Health Stroke Scale [NIHSS] > or = 4) within 2 days before stent placement.


RESULTS
The procedural success rate was 99%. Overall, there were 10 (10%) AEs within the 6 months: 4 (4%) minor strokes, 3 (3%) major strokes, and 3 (3%) deaths including a death from myocardial infarction. AE rate was 4.1% in stable and 25.9% in unstable patients. Restenosis at 6 months revealed 0% (0/59). Good outcome (modified Rankin Scale < or = 2) at 6 months was 97% (71/73) in stable and 67% (18/27) in unstable patients. Stepwise logistic regression model revealed that symptom pattern (unstable versus stable) was the only significant risk factor (OR, 8.167; 95% CI, 1.933-34.500; P = .004).


CONCLUSIONS
BEICS revealed a low AE and good outcome rate at 6 months, especially in the stable patients. Midterm outcome was also favorable in the unstable patient group.
Suh
D C
DC
Department of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, 388-One Pungnap-2 Dong, Songpa-Gu, Seoul 138-736, Korea. dcsuh@amc.seoul.kr
Kim
J K
JK
Choi
J W
JW
Choi
B S
BS
Pyun
H W
HW
Choi
Y J
YJ
Kim
M-H
MH
Yang
H R
HR
Ha
H I
HI
Kim
S J
SJ
Lee
D H
DH
Choi
C G
CG
Hahm
K D
KD
Kim
J S
JS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D001488:Basilar Artery / Q000473:pathology; D002343:Carotid Artery, Internal / Q000473:pathology; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000150:complications / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000473:pathology; D015607:Stents; D020521:Stroke / Q000209:etiology; D014711:Vertebral Artery / Q000473:pathology