G E Kim1, W Yoon2, S K Kim1, B C Kim3, T W Heo1, B H Baek1, Y Y Lee1, N Y Yim1. 1. From the Departments of Radiology (G.E.K., W.Y., S.K.K., T.W.H., B.H.B., Y.Y.L., N.Y.Y.). 2. From the Departments of Radiology (G.E.K., W.Y., S.K.K., T.W.H., B.H.B., Y.Y.L., N.Y.Y.) radyoon@jnu.ac.kr. 3. Neurology (B.C.K.), Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea.
Abstract
BACKGROUND AND PURPOSE: A major concern after emergent intracranial angioplasty in cases of acute stroke with underlying intracranial stenosis is the acute reocclusion of the treated arteries. This study reports the incidence and clinical outcomes of acute reocclusion of arteries following emergent intracranial angioplasty with or without stent placement for the management of patients with acute stroke with underlying intracranial atherosclerotic stenosis. MATERIALS AND METHODS: Forty-six patients with acute stroke received emergent intracranial angioplasty with or without stent placement for intracranial atherosclerotic stenosis and underwent follow-up head CTA. Acute reocclusion was defined as "hypoattenuation" within an arterial segment with discrete discontinuation of the arterial contrast column, both proximal and distal to the hypoattenuated lesion, on CTA performed before discharge. Angioplasty was defined as "suboptimal" if a residual stenosis of ≥50% was detected on the postprocedural angiography. Clinical and radiologic data of patients with and without reocclusion were compared. RESULTS: Of the 46 patients, 29 and 17 underwent angioplasty with and without stent placement, respectively. Acute reocclusion was observed in 6 patients (13%) and was more frequent among those with suboptimal angioplasty than among those without it (71.4% versus 2.6%, P < .001). The relative risk of acute reocclusion in patients with suboptimal angioplasty was 27.857 (95% confidence interval, 3.806-203.911). Furthermore, a good outcome was significantly less frequent in patients with acute reocclusion than in those without it (16.7% versus 67.5%, P = .028). CONCLUSIONS: Acute reocclusion of treated arteries was common after emergent intracranial angioplasty with or without stent placement in patients with acute stroke with intracranial atherosclerotic stenosis and was associated with a poor outcome. Suboptimal results of angioplasty appear to be associated with acute reocclusion, irrespective of whether stent placement was performed.
BACKGROUND AND PURPOSE: A major concern after emergent intracranial angioplasty in cases of acute stroke with underlying intracranial stenosis is the acute reocclusion of the treated arteries. This study reports the incidence and clinical outcomes of acute reocclusion of arteries following emergent intracranial angioplasty with or without stent placement for the management of patients with acute stroke with underlying intracranial atherosclerotic stenosis. MATERIALS AND METHODS: Forty-six patients with acute stroke received emergent intracranial angioplasty with or without stent placement for intracranial atherosclerotic stenosis and underwent follow-up head CTA. Acute reocclusion was defined as "hypoattenuation" within an arterial segment with discrete discontinuation of the arterial contrast column, both proximal and distal to the hypoattenuated lesion, on CTA performed before discharge. Angioplasty was defined as "suboptimal" if a residual stenosis of ≥50% was detected on the postprocedural angiography. Clinical and radiologic data of patients with and without reocclusion were compared. RESULTS: Of the 46 patients, 29 and 17 underwent angioplasty with and without stent placement, respectively. Acute reocclusion was observed in 6 patients (13%) and was more frequent among those with suboptimal angioplasty than among those without it (71.4% versus 2.6%, P < .001). The relative risk of acute reocclusion in patients with suboptimal angioplasty was 27.857 (95% confidence interval, 3.806-203.911). Furthermore, a good outcome was significantly less frequent in patients with acute reocclusion than in those without it (16.7% versus 67.5%, P = .028). CONCLUSIONS: Acute reocclusion of treated arteries was common after emergent intracranial angioplasty with or without stent placement in patients with acute stroke with intracranial atherosclerotic stenosis and was associated with a poor outcome. Suboptimal results of angioplasty appear to be associated with acute reocclusion, irrespective of whether stent placement was performed.
Authors: Ameer E Hassan; Victor M Ringheanu; Laurie Preston; Wondwossen G Tekle; Adnan I Qureshi Journal: Interv Neuroradiol Date: 2021-09-13 Impact factor: 1.764
Authors: Christian Paul Stracke; Jens Fiehler; Lukas Meyer; Götz Thomalla; Lars Udo Krause; Stephan Lowens; Jan Rothaupt; Byung Moon Kim; Ji Hoe Heo; Leonard L L Yeo; Tommy Andersson; Christoph Kabbasch; Franziska Dorn; Rene Chapot; Uta Hanning Journal: J Am Heart Assoc Date: 2020-03-03 Impact factor: 5.501
Authors: Jin Soo Lee; Seong-Joon Lee; Joon Sang Yoo; Jeong-Ho Hong; Chang-Hyun Kim; Yong-Won Kim; Dong-Hun Kang; Yong-Sun Kim; Ji Man Hong; Jin Wook Choi; Bruce Ovbiagele; Andrew M Demchuk; Sung-Il Sohn; Yang-Ha Hwang Journal: J Stroke Date: 2018-09-30 Impact factor: 6.967