title: Multicenter analysis of stenting in symptomatic intracranial atherosclerosis.
abstract: BACKGROUND
  Stenting for symptomatic intracranial atherosclerotic disease is a therapeutic option in patients in whom medical therapy fails.
  
  
  OBJECTIVE
  To determine the periprocedural complication rates and mid-term restenosis rates in patients treated with balloon-expandable stents (BESs) compared with self-expanding stents (SESs).
  
  
  METHODS
  A retrospective review of consecutive patients treated with intracranial stents at 5 institutions was performed. Predictors of 30-day stroke and death as well as mid-term restenosis rates were analyzed.
  
  
  RESULTS
  A total of 670 lesions were treated in 637 patients with a mean age of 57 ± 13 years. A total of 454 lesions (68%) were treated with BESs and 216 lesions (32%) with SESs. The overall 30-day periprocedural complication rate was 6.1%, without any difference noted between the 2 groups. Patients treated within 24 hours of the index event were significantly more likely to have experienced a periprocedural complication (odds ratio [OR], 4.0; 95% confidence interval [CI]: 1.7-6.7; P < .007), whereas focal lesions were less likely to have a complication (OR, 0.31; 95% CI: 0.13-0.72; P < .001). Midterm restenosis was less likely in patients with a lower percentage of posttreatment stenosis (OR, 0.97; 95% CI: 0.95-0.99; P < .006), which was more common in BES-treated patients and focal concentric lesions (OR, 0.33; 95% CI: 0.23-0.55; P < .0001).
  
  
  CONCLUSIONS
  BESs have periprocedural complication rates similar to those of SESs. Less posttreatment stenosis was associated with lower rates of mid-term restenosis. Future randomized trials comparing BESs and SESs may help to identify the stent type that is safest and most durable.
authors.affiliation: Beijing Tiantan Hospital, Beijing, China.
authors.forename: Wei-Jian
authors.initials: WJ
authors.lastname: Jiang
authors.forename: Esteban
authors.initials: E
authors.lastname: Cheng-Ching
authors.forename: Alex
authors.initials: A
authors.lastname: Abou-Chebl
authors.forename: Osama O
authors.initials: OO
authors.lastname: Zaidat
authors.forename: Tudor G
authors.initials: TG
authors.lastname: Jovin
authors.forename: Junaid
authors.initials: J
authors.lastname: Kalia
authors.forename: Muhammad Shazam
authors.initials: MS
authors.lastname: Hussain
authors.forename: Ridwan
authors.initials: R
authors.lastname: Lin
authors.forename: Amer M
authors.initials: AM
authors.lastname: Malik
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Hui
authors.forename: Rishi
authors.initials: R
authors.lastname: Gupta
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome