Long-Term Evolutionary Change in the Lumen of Intracranial Atherosclerotic Stenosis Following Angioplasty and Stenting
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AbstractBACKGROUND:
Angioplasty and stenting is a recognized treatment option for patients with intracranial atherosclerosis.

OBJECTIVE:
To evaluate the long-term evolutionary luminal changes of intracranial atherosclerosis after angioplasty and stenting.

METHODS:
This was a retrospective study with patient consent. Eighty-two patients presenting with acute and minor cerebral ischemia due to stenosis ≥70%, who had received medical therapy with or without stenting (Wingspan), were invited. Luminal imaging was provided using 3-dimensional rotational angiography (3-DRA) at baseline and 12 mo, and cone-beam computed tomography angiography with intravenous contrast (CBCT) was provided at follow-up (median 82.4 mo [interquartile range 61.9-96.9 mo]).

RESULTS:
Thirty-six patients in the stenting group and 26 patients in the medical group were recruited and completed the study. There was no statistically significant difference in demographics between the 2 patient groups. The luminal gain at 12 or 80 mo as compared to baseline in the stenting group was significantly greater than that in the medical group (12 mo: median gain 30% vs 7.2%, P < .001; 80 mo: median gain 42.9% vs 7.2%, P < .0001). Luminal loss or unchanged lumen was correlated with recurrent ischemic event. The differences in the stenosis degree assessment between CBCT and 3-DRA in the same 10 patients with or without stenting were 1.2 ± 0.6% or 0.2 ± 0.06%, respectively. There was a correlation between recurrent ischemic events and luminal loss.

CONCLUSION:
Arterial lumen after angioplasty and stenting can probably be well maintained and delayed luminal gain does occur, long-term luminal loss is associated with recurrent ischemic events, CBCT might be useful as a less-invasive means for long-term assessment.
All Author(s) ListYu Simon C H Yu, Lau Tiffany W W, Wong Simon S M, Lee Kwok Tung, Wong Lawrence K S, Leung Thomas W H
Journal nameOperative Neurosurgery
Year2018
Month2
Volume Number14
Issue Number2
PublisherOxford University Press
Pages128 - 138
ISSN2332-4252
eISSN2332-4260
LanguagesEnglish-United Kingdom
KeywordsCone-beam CT, Angiography, Angioplasty and stenting, Intracranial atherosclerotic stenosis

Last updated on 2020-06-08 at 03:24