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Early versus delayed stenting for intracranial atherosclerotic artery stenosis with ischemic stroke

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机构: [1]Department of Neurology and Interventional Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China [2]Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China [3]Department of Neurology and Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, Beijing, China
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关键词: atherosclerosis stenosis stent stroke

摘要:
Objective: To evaluate the clinical outcomes of early stenting (≤14 days) or late stenting (>14 days) in patients who underwent intracranial stent placement. Methods: Patients with ischemic stroke caused by 70-99% intracranial atherosclerotic stenosis combined with poor collaterals were enrolled. The early stenting group, who underwent stenting within 14 days of last ischemic symptoms, were compared with the late stenting group who underwent stenting >14 days from last ischemic symptom. The patients were treated either with a balloon-mounted stent or a self-expanding stent as determined by the operators following a guideline. The baseline characteristics and clinical outcomes were evaluated and compared. Results: One hundred and fifteen stroke patients were recruited into the study. Four patients (4/41) in the early stenting group and two patients (2/74) in the late stenting group were diagnosed with a cerebral vascular event associated with stenting within 3 days (p=0.184). In the long-term follow-up, eight patients in the early stenting group had restenosis ≥50%, which was higher than patients in the late stenting group (8/41 vs 4/74, p=0.018). The total rates of any ischemic stroke, transient ischemic attack, hemorrhagic stroke, and death in the early stenting group were higher than in the late stenting group (9/41 vs 6/74, p=0.035). The recurrence rate of ischemic stroke in the early stenting group was higher than in the late stenting group (5/41 vs 2/74, p=0.041). Conclusions: Stent placement in the setting of ischemic stroke caused by intracranial artery stenosis within 14 days may confer a higher risk of long-time cerebral vascular events and lead to a higher risk of restenosis. Clinical trial registration: NCT01968122. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

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出版当年[2018]版:
大类 | 3 区 医学
小类 | 2 区 外科 3 区 神经成像
最新[2023]版:
大类 | 1 区 医学
小类 | 1 区 神经成像 1 区 外科
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第一作者机构: [1]Department of Neurology and Interventional Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
通讯作者:
通讯机构: [1]Department of Neurology and Interventional Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China [*1]Department of Neurology and Interventional Neurology The Affiliated Hospital of Qingdao University Qingdao Shandong China
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