Submaximal primary angioplasty for symptomatic intracranial atherosclerosis: peri-procedural complications and long-term outcomes

Neuroradiology. 2019 Jan;61(1):97-102. doi: 10.1007/s00234-018-2133-y. Epub 2018 Nov 28.

Abstract

Purpose: The aim of our study is to report the peri-procedural complications and long-term stroke recurrent rate of symptomatic intracranial atherosclerosis (ICAS) patients who underwent submaximal primary angioplasty.

Methods: This is a retrospective analysis of consecutive patients in a single center who underwent submaximal primary angioplasty between January 1, 2012 and December 31, 2015. The peri-procedural complications and long-term outcomes are reported.

Results: Primary angioplasty was successfully performed in 129 patients (97.0%). The mean degree of pre-procedural stenosis was 81.9 ± 10.2%, and the degree of residual stenosis was 40.7 ± 19.1%. There were nine (6.8%) peri-procedural complications within 30 days, including seven ischemic strokes, one subarachnoid hemorrhage, and one asymptomatic intracerebral hemorrhage. None of them resulted in death. One-year follow-up was available in 122 patients (91.7%). Three more ischemic strokes (2.3%) which were in the territory of the treated artery occurred between 30 days and 1 year. The 1-year stroke and death rate was 9.0%, including peri-procedural stroke. Kaplan-Meier analysis showed a 3-year stroke-free survival of 87.2%.

Conclusion: Submaximal primary angioplasty can be performed with a low peri-procedural complication rate and relatively good clinical outcome at long-term follow-up for symptomatic ICAS patients.

Keywords: Angioplasty; Atherosclerosis; Intervention; Stroke.

MeSH terms

  • Angioplasty, Balloon / adverse effects
  • Angioplasty, Balloon / methods*
  • Anticoagulants / administration & dosage
  • Cerebral Angiography
  • Comorbidity
  • Female
  • Humans
  • Intracranial Arteriosclerosis / diagnostic imaging
  • Intracranial Arteriosclerosis / therapy*
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Treatment Outcome

Substances

  • Anticoagulants