Significant improvement of procedural safety in stenting for basilar stenosis: A historically controlled study
- PMID: 36550875
- PMCID: PMC9771323
- DOI: 10.1097/MD.0000000000032186
Significant improvement of procedural safety in stenting for basilar stenosis: A historically controlled study
Abstract
The basilar artery has the most perioperative complications in stenting compared to the other intracranial arteries. We aim to study whether the procedural safety in stenting for basilar stenosis has improved. This study was a single-arm, non-randomized trial that included historically controlled patients for comparison. Between January 2012 and March 2019, 147 consecutive patients with symptomatic basilar stenoses receiving elective stenting treatment were included in current basilar artery stenting (BAS) group. The prospectively collected and registered 120 patients by the same interventional team from September 2001 to November 2011 were set as historical BAS group for control. A total of 267 individuals were included in this study, with a mean age of 59.5 ± 8.1 years. The proportion of patients with lesion length >15 mm was 26.5% (39/147) in the current BAS group versus 4.2% (5/120) in the historical BAS group. We found significant differences between these 2 groups in Mori A (17.7% vs 42.5%) and Mori C patients (42.9% vs 13.3%). The proportion of patients receiving preoperative high-resolution magnetic resonance (HRMRI) evaluation was 83.0% (122/147) in the current BAS group versus 20.8% (25/120) in the historical group (P < .05). Balloon-expendable stent (BES) (n = 1), Wingspan (n = 34), and Enterprise (n = 112) stents were placed in the current BAS group. In contrast, only balloon-expendable stent (BES) (n = 48) and Wingspan (n = 72) were deployed in the historical BAS group. The incidence of the safety endpoint (SE) was 4.1% (involving 6 patients) in the current BAS group versus 11.7% (involving 14 patients) in the historical BAS group (P < .05). In multivariate analysis, no risk factor was associated with the occurrence of the safety endpoint (SE). When BAS cases operated by the surgical team accumulated to 120 to 150, the incidence of complications decreased significantly. This is the largest sample size study to discuss the safety of BAS. The significantly decreased incidence of complications indicates that the improving technical measures and the accumulation of operation experience are necessary.
Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.
Conflict of interest statement
The authors have no funding and conflicts of interest to disclose.
Figures
Similar articles
-
Percutaneous transluminal angioplasty and/or stenting for the treatment of basilar artery stenosis: a systematic review and meta-analysis.Neuroradiology. 2023 Jun;65(6):985-1000. doi: 10.1007/s00234-023-03124-x. Epub 2023 Mar 7. Neuroradiology. 2023. PMID: 36881121 Review.
-
Comparison of safety and mid-term effects between direct stenting and angioplasty before stenting in the basilar artery.Clin Neurol Neurosurg. 2020 Jun;193:105773. doi: 10.1016/j.clineuro.2020.105773. Epub 2020 Mar 3. Clin Neurol Neurosurg. 2020. PMID: 32169743
-
Stenting for peripheral artery disease of the lower extremities: an evidence-based analysis.Ont Health Technol Assess Ser. 2010;10(18):1-88. Epub 2010 Sep 1. Ont Health Technol Assess Ser. 2010. PMID: 23074395 Free PMC article.
-
Primary nitinol stenting in femoropopliteal occlusive disease: a meta-analysis of randomized controlled trials.J Endovasc Ther. 2012 Oct;19(5):585-95. doi: 10.1583/JEVT-12-3898R.1. J Endovasc Ther. 2012. PMID: 23046322 Review.
-
Stent design lowers angiographic but not clinical adverse events in stenting of symptomatic intracranial stenosis - results of a single center study with 100 consecutive patients.Int J Stroke. 2013 Feb;8(2):87-94. doi: 10.1111/j.1747-4949.2011.00715.x. Epub 2012 Feb 1. Int J Stroke. 2013. PMID: 22296983
References
-
- Qureshi AI, Ziai WC, Yahia AM, et al. . Stroke-free survival and its determinants in patients with symptomatic vertebrobasilar stenosis: a multicenter study. Neurosurgery. 2003;52:1033–9; discussion 1039. - PubMed
-
- The Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Study Group. Prognosis of patients with symptomatic vertebral or basilar artery stenosis. The Warfarin-Aspirin symptomatic intracranial disease (WASID) study group. Stroke. 1998;29:1389–92. - PubMed
-
- Jiang WJ, Du B, Hon SF, et al. . Do patients with basilar or vertebral artery stenosis have a higher stroke incidence poststenting? J Neurointerv Surg. 2010;2:50–4. - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources