title: Adjuvant revascularization of intracranial artery occlusion with angioplasty and/or stenting.
abstract: BACKGROUND
  In conjunction with intravenous and/or intra-arterial thrombolysis, adjuvant revascularization of intracranial artery occlusion by angioplasty vs. stenting remains controversial. We evaluated outcome in patients with intracranial occlusion after angioplasty and/or stenting.
  
  
  METHODS
  Thirty-three patients who underwent angioplasty or stenting (17 stenting and 16 angioplasty) for intracranial arterial occlusion during the past 5 years were enrolled from prospective neurointerventional database. We compared recanalization rate [defined as thrombolysis in myocardial infarction (TIMI) grade II/III flow], adverse events, and clinical outcome [modified Rankin scale (mRS) at 1 and 6 months]. We also tried to determine independent variables associated with clinical outcome.
  
  
  RESULTS
  Median initial National Institutes of Health Stroke Scale (NIHSS) was 13 and median time to treatment was 12 h from symptom onset. The successful recanalization rate was mean 79%. Symptomatic hemorrhage occurred in 15% (5/33). Events (27%, 9/33) at 1 month included four deaths, four major, and one minor stroke. Good outcome (mRS <or= 2) was achieved in 17 patients (52%) at 6 months and was significantly related to age, initial NIHSS, TIMI flow, and stenting on bivariate analysis. On multivariable analysis, stenting was the only variable significantly associated with a 6-month, good clinical outcome (OR, 14.48; 95% CI, 1.76 to 118.93; p = 0.013)
  
  
  CONCLUSIONS
  Intracranial revascularization with angioplasty and/or stenting may improve the clinical outcome in selected patients with intracranial occlusion. Multiple factors are related to favorable clinical outcome.
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-2dong, Songpa-Gu, Seoul, 138-736, Korea.
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Choi
authors.forename: Jae Kyun
authors.initials: JK
authors.lastname: Kim
authors.forename: Byung Se
authors.initials: BS
authors.lastname: Choi
authors.forename: Jeoung Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Hae Jun
authors.initials: HJ
authors.lastname: Hwang
authors.forename: Jong Sung
authors.initials: JS
authors.lastname: Kim
authors.forename: Sang Joon
authors.initials: SJ
authors.lastname: Kim
authors.forename: Dae Chul
authors.initials: DC
authors.lastname: Suh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D017130:Angioplasty / Q000379:methods*; D001921:Brain / Q000098:blood supply / Q000473:pathology; D002548:Cerebral Revascularization / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D020765:Intracranial Arterial Diseases / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D020300:Intracranial Hemorrhages / Q000150:complications; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D015607:Stents; D020521:Stroke / Q000150:complications; D016896:Treatment Outcome; D055815:Young Adult