In-Hospital Complication Rates After Stent Treatment of 388 Symptomatic Intracranial Stenoses Results From the INTRASTENT Multicentric Registry

被引:64
作者
Kurre, Wiebke [1 ]
Berkefeld, Joachim
Brassel, Friedhelm [7 ]
Bruening, Roland [4 ]
Eckert, Bernd [3 ]
Kamek, Seniye
Klein, Guenther E. [11 ]
Knauth, Michael [2 ]
Liebig, Thomas [8 ]
Maskova, Jana [12 ]
Mucha, Dirk
Neumann-Haefelin, Tobias
Pilgram-Pastor, Sara [2 ]
Sitzer, Matthias [9 ]
Sonnberger, Michael [10 ]
Tietke, Mark [6 ]
Trenkler, Johannes [10 ]
Turowski, Bernd [5 ]
机构
[1] Goethe Univ Frankfurt, Dept Neuroradiol, D-60528 Frankfurt, Germany
[2] Univ Gottingen, D-3400 Gottingen, Germany
[3] AK Altona Hamburg, Hamburg, Germany
[4] Asklepios Klin Barmbek Hamburg, Hamburg, Germany
[5] Univ Dusseldorf, D-4000 Dusseldorf, Germany
[6] Univ Kiel, D-24098 Kiel, Germany
[7] Wedau Kliniken Duisburg, Duisburg, Germany
[8] Univ Hosp Rechts Isar Munich, Munich, Germany
[9] Klinikum Herford, Herford, Germany
[10] Landesnervenklin Wagner Jauregg Linz, Linz, Austria
[11] Graz Univ, A-8010 Graz, Austria
[12] Cent Mil Hosp Prague, Prague, Czech Republic
关键词
intracranial angioplasty; intracranial atherosclerosis; intracranial stenosis; intracranial stenting; PERFORATING BRANCHES; ARTERIAL-STENOSIS; STROKE; ANATOMY;
D O I
10.1161/STROKEAHA.109.568063
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose-Stenting is increasingly used as an adjunct to medical therapy in symptomatic intracranial stenoses. High periprocedural adverse event rates are one of the limitations of endovascular treatment. Data from the INTRASTENT multicentric registry should demonstrate in-hospital complications at the current stage of clinical development of the stent procedure. Methods-Participating centers entered the records of all their consecutive intracranial stent procedures into the database. To determine the clinical outcome in the acute phase, we distinguished transient ischemic attack/nondisabling stroke (modified Rankin Scale <2), disabling stroke, death, and intracranial hemorrhage as clinical complications and analyzed whether they were associated with patient-or stenosis-related risk factors. Results-Data from 372 patients with 388 stenoses proved 4.8% disabling strokes and 2.2% deaths. Transient or minor events were detected in 5.4% of the cases. Hemorrhagic events (3.5%) occurred more frequently after treatment of middle cerebral artery stenoses (P = 0.004) and were associated with significantly higher morbidity and mortality rates. Ischemic strokes by compromise of perforating branches were detected mainly in the posterior circulation. However, the overall rate of severe adverse events was not dependent from location, degree, and morphology of the stenosis or from patient's age, gender, vascular risk factors, or type of qualifying event. Conclusion-The complication rates within the registry are within the limits of previously published data. Severe adverse events were equally distributed between potential risk groups with similar rates but different types of main complications in the anterior and posterior circulation. (Stroke. 2010;41:494-498.)
引用
收藏
页码:494 / 498
页数:5
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