title: Risk factors associated with major cerebrovascular complications after intracranial stenting.
abstract: BACKGROUND
  There are limited data on the relationship between patient and site characteristics and clinical outcomes after intracranial stenting.
  
  
  METHODS
  We performed a multivariable analysis that correlated patient and site characteristics with the occurrence of the primary endpoint (any stroke or death within 30 days of stenting or stroke in the territory of the stented artery beyond 30 days) in 160 patients enrolled in this stenting registry. All patients presented with an ischemic stroke, TIA, or other cerebral ischemic event (e.g., vertebrobasilar insufficiency) in the territory of a suspected 50-99% stenosis of a major intracranial artery while on antithrombotic therapy.
  
  
  RESULTS
  Cerebral angiography confirmed that 99% (158/160) of patients had a 50-99% stenosis. In multivariable analysis, the primary endpoint was associated with posterior circulation stenosis (vs anterior circulation) (hazard ratio [HR] 3.4, 95% confidence interval [CI] 1.2-9.3, p = 0.018), stenting at low enrollment sites (< 10 patients each) (vs high enrollment site) (HR 2.8, 95% CI 1.1-7.6, p = 0.038), < or = 10 days from qualifying event to stenting (vs > or = 10 days) (HR 2.7, 95% CI 1.0-7.8, p = 0.058), and stroke as a qualifying event (vs TIA/other) (HR 3.2, 95% CI 0.9-11.2, p = 0.064). There was no significant difference in the primary endpoint based on age, gender, race, or percent stenosis (50-69% vs 70-99%).
  
  
  CONCLUSIONS
  Major cerebrovascular complications after intracranial stenting may be associated with posterior circulation stenosis, low volume sites, stenting soon after a qualifying event, and stroke as the qualifying event. These factors will need to be monitored in future trials of intracranial stenting.
authors.affiliation: Emory University, Atlanta, GA, USA. fnahab@emory.edu
authors.forename: F
authors.initials: F
authors.lastname: Nahab
authors.forename: M J
authors.initials: MJ
authors.lastname: Lynn
authors.forename: S E
authors.initials: SE
authors.lastname: Kasner
authors.forename: M J
authors.initials: MJ
authors.lastname: Alexander
authors.forename: R
authors.initials: R
authors.lastname: Klucznik
authors.forename: O O
authors.initials: OO
authors.lastname: Zaidat
authors.forename: J
authors.initials: J
authors.lastname: Chaloupka
authors.forename: H
authors.initials: H
authors.lastname: Lutsep
authors.forename: S
authors.initials: S
authors.lastname: Barnwell
authors.forename: M
authors.initials: M
authors.lastname: Mawad
authors.forename: B
authors.initials: B
authors.lastname: Lane
authors.forename: M I
authors.initials: MI
authors.lastname: Chimowitz
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000368:Aged; D020520:Brain Infarction / Q000209:etiology / Q000401:mortality; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D020767:Intracranial Thrombosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011183:Postoperative Complications / Q000401:mortality*; D011361:Professional Competence / Q000706:statistics & numerical data; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects* / Q000706:statistics & numerical data; D020521:Stroke / Q000209:etiology* / Q000401:mortality*; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000401:mortality*; D014715:Vertebrobasilar Insufficiency / Q000628:therapy
chemical_list: D010975:Platelet Aggregation Inhibitors