Analysis of periinterventional complications of intracranial angioplasty and stenting: A single center experience

作者：Silber Toni; Ziemann Ulf; Ernemann Ulrike; Bischof Felix^*

来源：European Journal of Radiology, 2014, 83(12): 2190-2195.

DOI：10.1016/j.ejrad.2014.08.018

• Intracranial stenting
• Periinterventional risk
• 30-day-outcome

Background and purpose: Treatment of symptomatic intracranial atherosclerotic disease by angioplasty and stenting (PTAS) is limited by a high rate of periinterventional strokes. We performed a detailed analysis of these strokes at our center in order to identify strategies to reduce the risk of periinterventional complications. %26lt;br%26gt;Methods: Case records and imaging data of 80 patients with a symptomatic 70-99% stenosis of a major intracranial artery treated with PTAS between July 2007 and December 2013 were reviewed. All patients had a sufficient response to aspirin and clopidogrel. Periinterventional strokes were categorized as either ischemic (perforator territory, distal embolic or delayed stent thrombosis) or hemorrhagic (intra-parenchymal, subarachnoid). %26lt;br%26gt;Results: Periinterventional complications occurred in 6180(7.5%) patients, consisting of 2 ischemic strokes (2.5%, both perforator territory), 3 hemorrhagic strokes (3.8%, 2 intraparenchymal due to reperfusion injury, 1 subarachnoid due to vessel rupture) and one death (1.3%) unrelated to stroke. All strokes occurred within 24 h after PTAS. %26lt;br%26gt;Conclusion: Our retrospective data analysis suggests that the risk of periinterventional stroke after PTAS of symptomatic intracranial atherosclerotic disease might be reduced by sufficient antiplatelet therapy and optimized management of patients with high risk for reperfusion injury or perforator strokes, including selection of a stenting device adapted to individual vessel morphology.

• 出版日期2014-12