title: National trends in utilization and outcomes of angioplasty and stenting for revascularization in intracranial stenosis.
abstract: BACKGROUND
  Angioplasty and intracranial stenting (ICS) are both endovascular revascularization procedures that have emerged as treatment options for intracranial atherosclerotic disease (ICAD). Some believe angioplasty alone is better, while others believe stenting is better. This study examines recent trends in utilization and outcomes of angioplasty alone and ICS in the United States using a population-based cohort.
  
  
  METHODS
  The National Inpatient Sample (NIS) database was queried for patients with ICAD who underwent angioplasty or ICS from 2005 to 2010.
  
  
  RESULTS
  There were 1115 patients (angioplasty: n=495, ICS: n=620) with ICAD who underwent endovascular revascularization. Over time, the number of endovascular revascularization procedures increased. The percentage of symptomatic patients (p=0.015) as well as in the number of comorbidities of patients treated (p<0.001) also increased. Combined post-procedure stroke and death rates were 16% and 28.9% for angioplasty and ICS, respectively (p<0.001). A larger percentage of angioplasty patients presented symptomatically compared to those who underwent ICS (p<0.001).
  
  
  CONCLUSIONS
  Angioplasty appears to be associated with higher rates of peri-procedural complications; however, that may represent patient selection bias. Further studies are needed to identify patients who would benefit from revascularization and to clarify the roles of angioplasty and ICS.
authors: Department of Neurosurgery, New York University School of Medicine, New York, USA.
authors: Omar
authors: O
authors: Tanweer
authors: Department of Neurosurgery, New York University School of Medicine, New York, USA. Electronic address: Taylor.Wilson5@gmail.com.
authors: Taylor A
authors: TA
authors: Wilson
authors: Department of Neurosurgery, New York University School of Medicine, New York, USA.
authors: Antonios
authors: A
authors: El Helou
authors: Department of Radiology, New York University School of Medicine, New York, USA.
authors: Tibor
authors: T
authors: Becske
authors: Department of Neurosurgery, New York University School of Medicine, New York, USA. Electronic address: Howard.Riina@nyumc.org.
authors: Howard A
authors: HA
authors: Riina
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects / Q000379:methods* / Q000639:trends; D002548:Cerebral Revascularization / Q000379:methods* / Q000639:trends; D003251:Constriction, Pathologic / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D020521:Stroke; D016896:Treatment Outcome
keywords: Angioplasty; ICAD; ICS; Intracranial atherosclerosis disease; Intracranial stenosis; Intracranial stenting; National Inpatient Sample database; intracranial atherosclerotic disease; intracranial stenting