Thirty-Day Outcome of a Multicenter Registry Study of Stenting for Symptomatic Intracranial Artery Stenosis in China

Zhongrong Miao; Yong Zhang; Jie Shuai; Changchun Jiang; Qiyi Zhu; Kangning Chen; Li Liu; Baomin Li; Xiangqun Shi; Lianbo Gao; Yajie Liu; Feng Wang; Yongli Li; Tieyan Liu; Hongbo Zheng; Yilong Wang; Yongjun Wang; Study Group of Registry Study of Stenting for Symptomatic Intracranial Artery Stenosis in China

doi:10.1161/STROKEAHA.115.010549

Thirty-Day Outcome of a Multicenter Registry Study of Stenting for Symptomatic Intracranial Artery Stenosis in China

Stroke. 2015 Oct;46(10):2822-9. doi: 10.1161/STROKEAHA.115.010549. Epub 2015 Aug 18.

Authors

Zhongrong Miao¹, Yong Zhang², Jie Shuai², Changchun Jiang², Qiyi Zhu², Kangning Chen², Li Liu², Baomin Li², Xiangqun Shi², Lianbo Gao², Yajie Liu², Feng Wang², Yongli Li², Tieyan Liu², Hongbo Zheng², Yilong Wang², Yongjun Wang²; Study Group of Registry Study of Stenting for Symptomatic Intracranial Artery Stenosis in China

Collaborators

Study Group of Registry Study of Stenting for Symptomatic Intracranial Artery Stenosis in China:
Ning Ma, Dapeng Mo, Feng Gao, Ligang Song, Xuan Sun, Lian Liu, Xiaotong Xu, Xiaoqing Li, Xingquan Zhao, Liping Liu, Kehui Dong, Peiyi Gao, Jiong Zhan, Shaowu Li, Xianjun Zhang, Zhirong Zhang, Xiaojun Ji, Xiaohua Pan, Tianyou Zhang, Xia Li, Shugui Shi, Zhenghua Zhou, Yi An, Zhijun Dong, Xiaomei Gao, Jun Wang, Zhiqiang Zhang, Guozhen Zhang, Shaoju Shao, Xiongjun He, Kaifeng Li, Liang Zhang, Yongsheng Liu, Ke Li, Ruiyan Li, Minghui Chen, Yan Feng, Muke Zhou, Fayun Hu

Affiliations

¹ From the Departments of Interventional Neuroradiology (Z.M.) and Neurology (Yilong Wang, Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Department of Neurology, The Affiliated Hospital of Qingdao University Medical College, Qingdao, China (Y.Z.); Department of Neurology, Xin Qiao Hospital, Third Military Medical University, Chongqing, China (J.S.); Department of Neurology, Baotou Central Hospital, Baotou, China (C.J.); Department of Neurology, Linyi People's Hospital, Linyi, China (Q.Z.); Department of Neurology, Xi Nan Hospital, Third Military Medical University, Chongqing, China (K.C.); Department of Neurology, The Hospital of Chifeng City, Chifeng, China (L.L.); Department of Neurosurgery, The PLA General Hospital, Beijing, China (B.L.); Department of Neurology, The Lanzhou General Hospital of PLA, Lanzhou, China (X.S.); Department of Neurology, The Affiliated Fourth Hospital of China Medical University, Shenyang, China (L.G.); Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China (Yajie Liu); Department of Interventional Therapy, The First Affiliated Hospital of Dalian Medical University, Dalian, China (F.W.); Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China (Yongli Li); Department of Interventional Radiology, Cangzhou Central Hospital, Cangzhou, China (T.L.); and Department of Neurology, West China Hospital, Sichuan University, Chengdu, China (H.Z.). zhongrongm@163.com.
² From the Departments of Interventional Neuroradiology (Z.M.) and Neurology (Yilong Wang, Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Department of Neurology, The Affiliated Hospital of Qingdao University Medical College, Qingdao, China (Y.Z.); Department of Neurology, Xin Qiao Hospital, Third Military Medical University, Chongqing, China (J.S.); Department of Neurology, Baotou Central Hospital, Baotou, China (C.J.); Department of Neurology, Linyi People's Hospital, Linyi, China (Q.Z.); Department of Neurology, Xi Nan Hospital, Third Military Medical University, Chongqing, China (K.C.); Department of Neurology, The Hospital of Chifeng City, Chifeng, China (L.L.); Department of Neurosurgery, The PLA General Hospital, Beijing, China (B.L.); Department of Neurology, The Lanzhou General Hospital of PLA, Lanzhou, China (X.S.); Department of Neurology, The Affiliated Fourth Hospital of China Medical University, Shenyang, China (L.G.); Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China (Yajie Liu); Department of Interventional Therapy, The First Affiliated Hospital of Dalian Medical University, Dalian, China (F.W.); Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China (Yongli Li); Department of Interventional Radiology, Cangzhou Central Hospital, Cangzhou, China (T.L.); and Department of Neurology, West China Hospital, Sichuan University, Chengdu, China (H.Z.).

PMID: 26286544
DOI: 10.1161/STROKEAHA.115.010549

Abstract

Background and purpose: Although recent trials have suggested that stenting is worse than medical therapy for patients with severe symptomatic intracranial atherosclerotic stenosis, it is not clear whether this conclusion applies to a subset of patients with hypoperfusion symptoms. To justify for a new trial in China, we performed a multicenter prospective registry study to evaluate the safety and efficacy of endovascular stenting within 30 days for patients with severe symptomatic intracranial atherosclerotic stenosis.

Methods: Patients with symptomatic intracranial atherosclerotic stenosis caused by 70% to 99% stenosis combined with poor collaterals were enrolled. The patients were treated either with balloon-mounted stent or with balloon predilation plus self-expanding stent as determined by the operators following a guideline. The primary outcome within 30 days is stroke, transient ischemic attack, and death after stenting. The secondary outcome is successful revascularization. The baseline characteristics and outcomes of the 2 treatment groups were compared.

Results: From September 2013 to January 2015, among 354 consecutive patients, 300 patients (aged 58.3±9.78 years) were recruited, including 159 patients treated with balloon-mounted stent and 141 patients with balloon plus self-expanding stent. The 30-day rate of stroke, transient ischemic attack, and death was 4.3%. Successful revascularization was 97.3%. Patients treated with balloon-mounted stent were older, less likely to have middle cerebral artery lesions, more likely to have vertebral artery lesions, more likely to have Mori A lesions, less likely to have Mori C lesions, and likely to have lower degree of residual stenosis than patients treated with balloon plus self-expanding stent.

Conclusions: The short-term safety and efficacy of endovascular stenting for patients with severe symptomatic intracranial atherosclerotic stenosis in China is acceptable. Balloon-mounted stent may have lower degree of residual stenosis than self-expanding stent.

Clinical trial registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01968122.

Keywords: atherosclerosis; ischemic attack, transient; middle cerebral artery; stroke; vertebral artery.

Publication types

Clinical Trial
Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

China
Endovascular Procedures / instrumentation*
Endovascular Procedures / methods*
Female
Humans
Intracranial Arteriosclerosis / surgery*
Male
Middle Aged
Registries
Stents

Associated data

ClinicalTrials.gov/NCT01968122