In-hospital complication rates after stent treatment of 388 symptomatic intracranial stenoses: results from the INTRASTENT multicentric registry.
OBJECTIVE
Stenting is increasingly used as an adjunct to medical therapy in symptomatic intracranial stenoses. High periprocedural adverse event rates are one of the limitations of endovascular treatment. Data from the INTRASTENT multicentric registry should demonstrate in-hospital complications at the current stage of clinical development of the stent procedure.


METHODS
Participating centers entered the records of all their consecutive intracranial stent procedures into the database. To determine the clinical outcome in the acute phase, we distinguished transient ischemic attack/nondisabling stroke (modified Rankin Scale <2), disabling stroke, death, and intracranial hemorrhage as clinical complications and analyzed whether they were associated with patient- or stenosis-related risk factors.


RESULTS
Data from 372 patients with 388 stenoses proved 4.8% disabling strokes and 2.2% deaths. Transient or minor events were detected in 5.4% of the cases. Hemorrhagic events (3.5%) occurred more frequently after treatment of middle cerebral artery stenoses (P=0.004) and were associated with significantly higher morbidity and mortality rates. Ischemic strokes by compromise of perforating branches were detected mainly in the posterior circulation. However, the overall rate of severe adverse events was not dependent from location, degree, and morphology of the stenosis or from patient's age, gender, vascular risk factors, or type of qualifying event.


CONCLUSIONS
The complication rates within the registry are within the limits of previously published data. Severe adverse events were equally distributed between potential risk groups with similar rates but different types of main complications in the anterior and posterior circulation.
Kurre
Wiebke
W
Department of Neuroradiology, University of Frankfurt, Schleusenweg 2-16, 60528 Frankfurt, Germany. wiebke.kurre@kgu.de
Berkefeld
Joachim
J
Brassel
Friedhelm
F
Brüning
Roland
R
Eckert
Bernd
B
Kamek
Seniye
S
Klein
Guenther E
GE
Knauth
Michael
M
Liebig
Thomas
T
Maskova
Jana
J
Mucha
Dirk
D
Neumann-Haefelin
Tobias
T
Pilgram-Pastor
Sara
S
Sitzer
Matthias
M
Sonnberger
Michael
M
Tietke
Mark
M
Trenkler
Johannes
J
Turowski
Bernd
B
D000368:Aged; D017130:Angioplasty / Q000009:adverse effects* / Q000295:instrumentation / Q000639:trends; D003251:Constriction, Pathologic / Q000150:complications / Q000401:mortality / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000150:complications / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome