How Effective Is Endovascular Intracranial Revascularization in Stroke Prevention? Results from Borgess Medical Center Intracranial Revascularization Registry
被引:9
作者:
Al-Ali, F.
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机构:
Neurosurg Kalamazoo, Kalamazoo, MI 49048 USA
Borgess Med Ctr, Neurointervent Surg Serv, Kalamazoo, MI USA
Borgess Med Ctr, Diagnost Serv, Kalamazoo, MI USANeurosurg Kalamazoo, Kalamazoo, MI 49048 USA
Al-Ali, F.
[1
,3
,4
]
Cree, T.
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机构:
Borgess Med Ctr, Borgess Res Inst, Kalamazoo, MI USANeurosurg Kalamazoo, Kalamazoo, MI 49048 USA
Cree, T.
[2
]
Duan, L.
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机构:Neurosurg Kalamazoo, Kalamazoo, MI 49048 USA
Duan, L.
Hall, S.
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h-index: 0
机构:
Michigan State Univ, Kalamazoo Ctr Med Studies, Kalamazoo, MI USANeurosurg Kalamazoo, Kalamazoo, MI 49048 USA
Hall, S.
[5
]
Jefferson, A.
论文数: 0引用数: 0
h-index: 0
机构:
Borgess Med Ctr, Borgess Res Inst, Kalamazoo, MI USANeurosurg Kalamazoo, Kalamazoo, MI 49048 USA
Jefferson, A.
[2
]
Louis, S.
论文数: 0引用数: 0
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机构:
Borgess Med Ctr, Neurointervent Surg Serv, Kalamazoo, MI USA
Borgess Med Ctr, Diagnost Serv, Kalamazoo, MI USANeurosurg Kalamazoo, Kalamazoo, MI 49048 USA
Louis, S.
[3
,4
]
Major, K.
论文数: 0引用数: 0
h-index: 0
机构:
Borgess Med Ctr, Neurointervent Surg Serv, Kalamazoo, MI USA
Borgess Med Ctr, Diagnost Serv, Kalamazoo, MI USANeurosurg Kalamazoo, Kalamazoo, MI 49048 USA
Major, K.
[3
,4
]
Smoker, S.
论文数: 0引用数: 0
h-index: 0
机构:
Borgess Med Ctr, Neurointervent Surg Serv, Kalamazoo, MI USA
Borgess Med Ctr, Diagnost Serv, Kalamazoo, MI USANeurosurg Kalamazoo, Kalamazoo, MI 49048 USA
Smoker, S.
[3
,4
]
Walker, S.
论文数: 0引用数: 0
h-index: 0
机构:
Borgess Med Ctr, Borgess Res Inst, Kalamazoo, MI USANeurosurg Kalamazoo, Kalamazoo, MI 49048 USA
Walker, S.
[2
]
机构:
[1] Neurosurg Kalamazoo, Kalamazoo, MI 49048 USA
[2] Borgess Med Ctr, Borgess Res Inst, Kalamazoo, MI USA
[3] Borgess Med Ctr, Neurointervent Surg Serv, Kalamazoo, MI USA
[4] Borgess Med Ctr, Diagnost Serv, Kalamazoo, MI USA
[5] Michigan State Univ, Kalamazoo Ctr Med Studies, Kalamazoo, MI USA
BACKGROUND AND PURPOSE: The WASID study established the risk of subsequent ischemic stroke at 1 year in subjects with symptomatic intracranial atherosclerotic stenosis (70%-99%) at 18%. The efficacy of different methods of endovascular revascularization in stroke prevention still has not been established. We compared the stroke rate in our registry at 1 year following intervention with the WASID results to identify which method, if any, provides the most benefit in stroke prevention. This result from the BMC-IRR follows a previously published article comparing stent placement and angioplasty outcomes. MATERIALS AND METHODS: We maintained a nonrandomized single-center single-operator registry of consecutive symptomatic patients who underwent endovascular intracranial revascularization. Data were collected prospectively and retrospectively and analyzed retrospectively. Patients were treated with angioplasty, BMS, or self-expanding WS. To make our data comparable with that in the WASID study, we selected patients with a single lesion of 50%-99% stenosis undergoing a single intervention. Data was collected on patients until symptom recurrence, repeat intervention, or 1 year postintervention, whichever occurred first. RESULTS: We found that 115 patients fit the inclusion criteria, with 38 angioplasty, 28 BMS, and 49 WS cases. For patients with 70%-99% stenosis, the overall probability of stroke at 1 year postintervention was 19.3%. The overall stroke probability per device, independent of clinical presentation, was 12.5% for angioplasty, 20.2% for BMS, and 24.1% for WS. CONCLUSIONS: Compared with the WASID data, angioplasty appears to have a lower stroke rate after 1 year than medical therapy alone. However, neither stern-placement arm compared favorably with the WASID results.
机构:
SUNY Buffalo, Sch Med & Biomed Sci, Millard Fillmore Gates Hosp, Dept Neurosurg, Buffalo, NY 14260 USA
SUNY Buffalo, Sch Med & Biomed Sci, Millard Fillmore Gates Hosp, Toshiba Stroke Res Ctr, Buffalo, NY 14260 USACleveland Clin Fdn, Dept Neurosurg, Cleveland, OH 44195 USA
Levy, Elad I.
Turk, Aquilla S.
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机构:
Med Univ S Carolina, Dept Radiol, Charleston, SC 29425 USA
Med Univ S Carolina, Dept Neurosurg, Charleston, SC 29425 USACleveland Clin Fdn, Dept Neurosurg, Cleveland, OH 44195 USA
Turk, Aquilla S.
Albuquerque, Felipe C.
论文数: 0引用数: 0
h-index: 0
机构:
Barrow Neurol Inst, Dept Neurosurg, Phoenix, AZ 85013 USACleveland Clin Fdn, Dept Neurosurg, Cleveland, OH 44195 USA
机构:
SUNY Buffalo, Sch Med & Biomed Sci, Millard Fillmore Gates Hosp, Dept Neurosurg, Buffalo, NY 14260 USA
SUNY Buffalo, Sch Med & Biomed Sci, Millard Fillmore Gates Hosp, Toshiba Stroke Res Ctr, Buffalo, NY 14260 USACleveland Clin Fdn, Dept Neurosurg, Cleveland, OH 44195 USA
Levy, Elad I.
Turk, Aquilla S.
论文数: 0引用数: 0
h-index: 0
机构:
Med Univ S Carolina, Dept Radiol, Charleston, SC 29425 USA
Med Univ S Carolina, Dept Neurosurg, Charleston, SC 29425 USACleveland Clin Fdn, Dept Neurosurg, Cleveland, OH 44195 USA
Turk, Aquilla S.
Albuquerque, Felipe C.
论文数: 0引用数: 0
h-index: 0
机构:
Barrow Neurol Inst, Dept Neurosurg, Phoenix, AZ 85013 USACleveland Clin Fdn, Dept Neurosurg, Cleveland, OH 44195 USA