title: Intracranial stenting of subacute symptomatic atherosclerotic occlusion versus stenosis.
abstract: OBJECTIVE
  Limited data are available concerning the outcome of angioplasty/stenting for subacute atherosclerotic intracranial artery occlusion, which is often associated with progressive symptom development in the salvageable brain under ischemic threat due to poor collateral blood supply.
  
  
  METHODS
  Among 177 patients who underwent angioplasty and/or stenting for severe symptomatic intracranial steno-occlusion, 26 had subacute atherosclerotic intracranial artery occlusion. Outcome after stenting (N=22) was assessed according to procedural success (return of antegrade flow and residual stenosis<50%), adverse event (any stroke or death) rate, and restenosis (>50%) using weighted Cox proportional hazards regression in the overall cohort and in separate subgroups.
  
  
  RESULTS
  Successful recanalization was achieved in 95%. Three adverse events (13.6%) occurred among patients undergoing stenting for occlusion, including 2 major strokes and 1 nonprocedure-related death. Good outcome (modified Rankin Scale≤2) was achieved in 73%. In the overall cohort, no significant difference was observed between the occlusion and stenosis groups in terms of the risk of adverse events (hazard ratio for the occlusion group, 1.055; 95% CI, 0.29-3.90) or the risk of restenosis (hazard ratio for the occlusion group, 1.2; 95% CI, 0.19-7.72). A trend toward a higher rate of adverse events was observed in older age (>65 years), progressive worsening, balloon-expandable stent, and no history of a preprocedural P2Y12 assay.
  
  
  CONCLUSIONS
  In a cohort of patients undergoing angioplasty/stenting for subacute atherosclerotic intracranial artery occlusion, no significant difference in the rates of adverse events was observed. However, several factors, including age, tended to be associated with a higher event rate.
authors.affiliation: Department of Radiology, University of Ulsan, College of Medicine, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul 138-736, Korea.
authors.forename: Peng-Hua
authors.initials: PH
authors.lastname: Lü
authors.forename: Jee Won
authors.initials: JW
authors.lastname: Park
authors.forename: Soonchan
authors.initials: S
authors.lastname: Park
authors.forename: Jong Lim
authors.initials: JL
authors.lastname: Kim
authors.forename: Deok Hee
authors.initials: DH
authors.lastname: Lee
authors.forename: Sun Uck
authors.initials: SU
authors.lastname: Kwon
authors.forename: Jong Sung
authors.initials: JS
authors.lastname: Kim
authors.forename: Sung-Cheol
authors.initials: SC
authors.lastname: Yun
authors.forename: Dae Chul
authors.initials: DC
authors.lastname: Suh
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000379:methods*; D002533:Cerebral Angiography; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome