title: Safety and Efficacy Analyses of Angioplasty and Stenting for Severe Intracranial Arterial Stenosis: A Single-Center Retrospective Study in China.
abstract: BACKGROUND
  The value of percutaneous transluminal angioplasty and stenting (PTAS) in the context of aggressive medical treatment for severe intracranial artery stenosis (ICAS) is under debate. This study compared the effects of PTAS and aggressive medical treatment in patients with severe ICAS and transient ischemic attack or stroke.
  
  
  METHODS
  A retrospective cohort study was performed. Patients with severe ICAS were assigned to a PTAS group or aggressive medical treatment group, according to the angiographic features of the stenotic lesions. The primary outcome was defined as stroke or death within 30 days or cerebral ischemia occurring ipsilaterally to the qualifying artery beyond 30 days.
  
  
  RESULTS
  We included 220 patients: 48 in the PTAS group and 172 in the medical group. The median follow-up was 32 months. PTAS was not associated with an increased incidence of the primary outcomes (10/42 vs. 39/172, p=0.96) or increased risks of the secondary outcomes of stroke, cardiovascular events, major bleeding, or mortality. The results of log-rank tests did not support a significant difference in event-free survival as a primary outcome between the 2 groups (chi-square=0.07, p=0.79). Moreover, although not significantly greater, the mean survival of patients in the PTAS group appeared to be better than that among patients in the medical group, as indicated by the curve for cumulative survival.
  
  
  CONCLUSIONS
  A suitable PTAS procedure is safe for patients with severe ICAS, and no significant differences in incidence of recurrent stroke or death were found between PTAS and aggressive medication treatment.
authors.affiliation: Department of Neurology, The General Hospital of Lanzhou Military Command of the Chinese People's Liberation Army, Lanzhou, Gansu, China (mainland).
authors.forename: Rong
authors.initials: R
authors.lastname: Yin
authors.affiliation: Department of Neurology, The General Hospital of Lanzhou Military Command of the Chinese People's Liberation Army, Lanzhou, Gansu, China (mainland).
authors.forename: Fei
authors.initials: F
authors.lastname: Chang
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China (mainland).
authors.forename: Bo
authors.initials: B
authors.lastname: Hong
authors.affiliation: Department of Neurology, The General Hospital of Lanzhou Military Command of the Chinese People's Liberation Army, Lanzhou, Gansu, China (mainland).
authors.forename: Xiang-Qun
authors.initials: XQ
authors.lastname: Shi
authors.affiliation: Department of Neurology, The General Hospital of Lanzhou Military Command of the Chinese People's Liberation Army, Lanzhou, Gansu, China (mainland).
authors.forename: Guo-Zhen
authors.initials: GZ
authors.lastname: Zhang
authors.affiliation: Department of Neurology, The General Hospital of Lanzhou Military Command of the Chinese People's Liberation Army, Lanzhou, Gansu, China (mainland).
authors.forename: Zhao
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Neurology, The General Hospital of Lanzhou Military Command of the Chinese People's Liberation Army, Lanzhou, Gansu, China (mainland).
authors.forename: Zhi-Qiang
authors.initials: ZQ
authors.lastname: Zhang
authors.affiliation: Department of Neurology, The General Hospital of Lanzhou Military Command of the Chinese People's Liberation Army, Lanzhou, Gansu, China (mainland).
authors.forename: Ya-Xuan
authors.initials: YX
authors.lastname: Wei
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China (mainland).
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Liu
mesh_terms: D000368:Aged; D000792:Angiography; D017130:Angioplasty; D001158:Arteries / Q000503:physiopathology*; D020520:Brain Infarction; D001933:Brain Stem / Q000473:pathology; D002681:China; D003251:Constriction, Pathologic / Q000628:therapy; D018572:Disease-Free Survival; D005260:Female; D006470:Hemorrhage; D006801:Humans; D002546:Ischemic Attack, Transient / Q000473:pathology* / Q000628:therapy; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011312:Pressure; D012189:Retrospective Studies; D015607:Stents; D020521:Stroke; D016896:Treatment Outcome