Medium- and long-term effects of endovascular treatments for severely stenotic basilar arteries supported by multimodal imaging

Li, Yuanzhi; Li, Zhenfa; Song, Ligang; Xie, Weimin; Gong, Xianghao; He, Dan; Zhang, Xin

doi:10.1186/s12883-020-01863-5

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…It should be noted that TIA attributable to the target vessel was also recorded as the outcome, which may increase the event rate. Another two studies in China also used the Enterprise stent for symptomatic ICAS treatment, which yielded a successful operation rate of 100%, and the stroke or death rate within 30 days after the procedure was also low (12,19). However, the sample size of these two studies was small.…”

Section: Discussionmentioning

confidence: 99%

“…On account of its advancement and release by a catheter system, the device may be used as an alternative to the wingspan system for treating ICAS. So far, several studies had reported the efficacies of the Enterprise stenting for ICAS, but few studies have focused on the long-term outcome in a high-volume stroke center (11,(13)(14)(15)(16)(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Outcome of Enterprise Stenting for Symptomatic ICAS in a High-Volume Stroke Center

et al. 2021

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Background and Purpose: The Enterprise stent has been used for treating intracranial atherosclerotic stenosis (ICAS), but its long-term outcome remains unclear. The purpose of this study was to evaluate the long-term clinical efficacy of the Enterprise stent used for patients with symptomatic ICAS due to hypoperfusion.Method: Patients with symptomatic ICAS due to hypoperfusion treated with the Enterprise stents from a high-volume stroke center were evaluated. The successful recanalization was defined as the Modified Thrombolysis In Cerebral Infarction (mTICI) ≥ 2b. The stroke and neurological death that occurred within 72 h after the procedure as well as long-term clinical and imaging outcomes were analyzed.Results: Overall, 130 patients with 130 ICAS treated with the Enterprise stent were included in our study. The successful recanalization rate was 100%. The mean pre- and postprocedural stenosis was 82.9 ± 8.9% vs. 15.1 ± 8.4%. Periprocedural complications occurred in 5 (3.8%) patients within 72 h after the procedure. Clinical follow-up data were available in 125 (96.2%) patients (median, 24 months) and any stroke or neurological death was encountered in 6 (4.8%) patients. Angiographic follow-up data was obtained from 118 (90.8%) patients (median, 13.5 months). In addition, 1-year in-stent restenosis (>70%) was found in 17 (14.4%) patients, and among them, 4 (23.5%) patients were symptomatic.Conclusion: Deployment of Enterprise stent is safe for ICAS. The short-term and long-term outcomes were acceptable, but the efficacy of the Enterprise stent needs to be further evaluated in future studies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-Term Outcome of Enterprise Stenting for Symptomatic ICAS in a High-Volume Stroke Center

et al. 2021

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Percutaneous transluminal angioplasty and stenting (PTAS) in patients with symptomatic intracranial vertebrobasilar artery stenosis (IVBS)

Pourahmad,

Saleki,

Zoghi

et al. 2024

Stroke Vasc Neurol

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Background Approximately 20% of all transient ischaemic attacks (TIAs) and ischaemic strokes occur within the posterior circulation, with vertebrobasilar stenosis identified as the cause in roughly 25% of the cases. Studies have shown that about a quarter of these patients have atherosclerotic stenosis of at least 50% of the vertebrobasilar artery. Stenosis has been shown to be associated with an increased risk of 90-day recurrent vertebrobasilar stroke, particularly in the first few weeks, which is significantly higher when compared with patients with stenosis of the anterior circulation. Therefore, aggressive treatment is important for the patient’s prognosis. Stenting is emerging as a promising therapeutic strategy for persistent ischaemia events that do not respond to the best medical treatment, but it is not without complications. We systematically reviewed the literature on percutaneous transluminal angioplasty and stenting (PTAS) for intracranial vertebrobasilar artery stenosis (IVBS). Methods PubMed, Web-of-Science and Scopus were searched upon the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to include prospective/retrospective cohort, randomised/non-randomised clinical trials and case series studies describing PTAS for IVBS. Pooled rates of intervention-related complications and outcomes were analysed with random-effect model meta-analysis using StataMP V.18.0 software. Results 31 studies were found eligible which included 1928 cases. 1103 basilar artery stenosis cases were reported in 27 studies 0.65 (95% CI 0.53, 0.76), I2: 99.72%. 648 vertebral cases were reported in 18 studies 0.60 (95% CI 0.49, 0.70), I2: 97.49%. In four studies, the rate of vertebrobasilar stenosis cases calculated as a proportion of the total sample size was 0.10 (95% CI 0.05, 0. 15). Mean stenosis in 21 included studies was found to be 0.83 (95% CI 0.79, 0.88), I2: 0.00%, which shows variation of baseline stenosis between studies was minimal. 51 deaths were recorded in 24 studies. Meta-analysis of mortality showed the overall rate of mortality was 0.03 (95% CI 0.02, 0.05), I2: 44.90%. In 14 studies, symptomatic intracranial haemorrhage events were recorded at an overall rate of 0.01 (95% CI 0.00, 0.02), I2: 0.00%. Generally, a follow-up period of at least 3 months was reported in the included studies. Furthermore, procedural stroke/TIA was evaluated in seven studies, four of which reported no events (0.03 (95% CI 0.00, 0.08), I2: 20.38%). Mean time from initial symptoms to recanalisation was 23.98 (95% CI 18.56, 29.40), I2=98.8%, p=0.00 days. Conclusion In certain individuals with medically unresolved, severe, symptomatic and non-acute IVBS, elective vertebrobasilar PTAS appears to be both safe and effective. Various stent designs and angioplasty-assisted techniques should be taken into consideration based on the specific clinical and radiological traits of the lesions. Future randomised controlled trials are required to verify these results.

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The Association Between the Fibrinogen-to-Albumin Ratio and Intracranial Arterial Stenosis in Patients With Acute Ischemic Stroke

et al. 2023

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The association between the fibrinogen-to-albumin ratio (FAR) and intracranial arterial stenosis (ICAS) in patients with acute ischemic stroke (AIS) has not yet been reported. In this large-scale investigation, 7894 AIS patients with ICAS-evaluation imaging data from the Third China National Stroke Registry were included. ICAS was defined as >50% stenosis of the intracranial arteries. We dichotomized the degree of ICAS into stenosis and occlusion. The number of ICAS lesions was the total number of intracranial stenotic arteries. Fibrinogen and albumin levels were assessed in the central laboratory of Beijing Tiantan Hospital. Univariate and multivariate analyses with logistic regression were used to determine the association between the FAR quartiles and ICAS. A total of 3900 (49.66%) patients had ICAS. Compared with those of the lowest FAR quartile, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of the highest FAR quartile were 1.26 (1.10–1.44), 1.15 (.99–1.33), and 1.19 (1.01–1.39) for ICAS, symptomatic ICAS, and asymptomatic ICAS, respectively. An elevated FAR was also associated with occlusion (adjusted OR: 1.28, 95% CI: 1.10–1.49) and lesion number ≥2 (adjusted OR: 1.25, 95% CI: 1.07–1.45).

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Medium- and long-term effects of endovascular treatments for severely stenotic basilar arteries supported by multimodal imaging

Cited by 3 publications

References 20 publications

Long-Term Outcome of Enterprise Stenting for Symptomatic ICAS in a High-Volume Stroke Center

Long-Term Outcome of Enterprise Stenting for Symptomatic ICAS in a High-Volume Stroke Center

Percutaneous transluminal angioplasty and stenting (PTAS) in patients with symptomatic intracranial vertebrobasilar artery stenosis (IVBS)

The Association Between the Fibrinogen-to-Albumin Ratio and Intracranial Arterial Stenosis in Patients With Acute Ischemic Stroke

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