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Long-term clinical and angiographic outcome from angioplasty and stenting for intracranial stenosis

  • Original Article - Vascular Neurosurgery - Ischemia
  • Published:
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Abstract

Background

Severe intracranial atherosclerotic stenosis (ICAS) is a major cause of stroke. Although percutaneous transluminal angioplasty and stenting (PTAS) treatment methods have increased over the last decade as alternative therapies, there is debate regarding the best method of treatment, with medical and surgical therapies often suggested.

Methods

We analyzed the long-term follow-up results from 5 years of intracranial stenting for intracranial stenosis from three stroke centers. The primary endpoints were early stroke complications or death within 30 days after stent insertion, and the secondary endpoint was a recurrent stroke between 30 days and 60 months. Correlating factors and Kaplan–Meier survival curves for recurrent stroke and in-stent restenosis (ISR) were also obtained.

Results

Seventy-three PTAS in 71 patients were examined in this study. The primary and secondary endpoints were all 8.2% (n = 6), and restenosis was 13.7% (n = 10) during the 5-year follow-up. The primary endpoints were significantly frequent in the high National Institutes of Health Stroke Scale (NIHSS) and early stent (≤ 7 days after dual antiplatelet medication) groups. Secondary endpoint and ISR were identically frequent in the younger age group and in the presence of tandem stenosis in other major intracranial arteries. The cumulative probability of recurrent stroke and ISR at 60 months was 16.4% and 14.1%, respectively.

Conclusions

This study shows that PTAS is safe and effective for major ICAS. Reducing the early complication rate is still an important factor, despite the fact that long-term stroke recurrence was low.

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Authors and Affiliations

  1. Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Sang Kyu Park

  2. Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Sang Hyun Suh

  3. Department of Neurosurgery, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, Republic of Korea

    Kyeong Sool Jang & Dong Kyu Jang

  4. Department of Neurosurgery, Seoul Ewha Womans University Medical Center, Seoul, Republic of Korea

    Dong Young Jo

  5. Department of Neurosurgery, Seoul St. Mary’s Hospital, The Catholic University of Medicine, Seoul, Republic of Korea

    Yong Sam Shin

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  1. Sang Kyu Park
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Correspondence to Sang Hyun Suh.

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This article is part of the Topical Collection on Vascular Neurosurgery-Ischemia

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Park, S.K., Suh, S.H., Jang, K.S. et al. Long-term clinical and angiographic outcome from angioplasty and stenting for intracranial stenosis. Acta Neurochir 164, 1627–1634 (2022). https://doi.org/10.1007/s00701-022-05110-3

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  • DOI: https://doi.org/10.1007/s00701-022-05110-3

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