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Stenting severe intracranial stenosis can reduce stroke risk
Monday, 29 November 1999 19:00 | 
Patients with intracranial stenosis of at least 70 per cent have a lower risk of stroke following angioplasty and stenting, radiologists in China report in the February 6 issue of Neurology.
Patients with intracranial stenosis of at least 70 per cent have a lower risk of stroke following angioplasty and stenting, radiologists in China report in the February 6 issue of Neurology.
On the other hand, persons with less severe stenosis – 50 to 69 per cent narrowing – appear to gain little benefit from the same procedure, the investigators found.
Severe intracranial stenosis is associated with a 17 per cent or greater risk of lesion-related ischemic stroke within 1 year when treatment consists of aspirin or warfarin, lead author Dr. Wei-Jian Jiang and associates at The Capital University of Medical Sciences in Beijing note. The corresponding risk for patients with moderate stenosis is 7 to 8 per cent.
Their study included 121 patients with severe intracranial stenosis and 92 with moderate stenosis who had experienced a stroke or transient ischemic attack between 2001 and 2005. They underwent angioplasty and stenting, with follow-up until June 2006.
At 30 days post-procedure, the frequency of primary endpoints – lesion-related ischemic stroke, symptomatic brain hemorrhage or symptomatic subarachnoid hemorrhage – was 4.8 per cent in the severe-stenosis group and 4.3 per cent in the moderate-stenosis group.
At 1- and 2-year follow-up, the cumulative probability of a primary endpoint was 7.2 and 8.2 per cent in the severe stenosis group. In the moderate stenosis group, the cumulative probabilities were 5.3 and 8.3 per cent, respectively.
The two groups did not differ significantly in secondary end points – emergent cerebral revascularization, asymptomatic subarachnoid hemorrhage, non-lesion-related ischemic stroke, death from other vascular causes or other major hemorrhages.
Dr. Jiang's team concludes that angioplasty appeared to offer substantial benefit only to patients with severe stenosis. They advise randomized trials to corroborate their findings.
Neurology 2007;68:420-426.
On the other hand, persons with less severe stenosis – 50 to 69 per cent narrowing – appear to gain little benefit from the same procedure, the investigators found.
Severe intracranial stenosis is associated with a 17 per cent or greater risk of lesion-related ischemic stroke within 1 year when treatment consists of aspirin or warfarin, lead author Dr. Wei-Jian Jiang and associates at The Capital University of Medical Sciences in Beijing note. The corresponding risk for patients with moderate stenosis is 7 to 8 per cent.
Their study included 121 patients with severe intracranial stenosis and 92 with moderate stenosis who had experienced a stroke or transient ischemic attack between 2001 and 2005. They underwent angioplasty and stenting, with follow-up until June 2006.
At 30 days post-procedure, the frequency of primary endpoints – lesion-related ischemic stroke, symptomatic brain hemorrhage or symptomatic subarachnoid hemorrhage – was 4.8 per cent in the severe-stenosis group and 4.3 per cent in the moderate-stenosis group.
At 1- and 2-year follow-up, the cumulative probability of a primary endpoint was 7.2 and 8.2 per cent in the severe stenosis group. In the moderate stenosis group, the cumulative probabilities were 5.3 and 8.3 per cent, respectively.
The two groups did not differ significantly in secondary end points – emergent cerebral revascularization, asymptomatic subarachnoid hemorrhage, non-lesion-related ischemic stroke, death from other vascular causes or other major hemorrhages.
Dr. Jiang's team concludes that angioplasty appeared to offer substantial benefit only to patients with severe stenosis. They advise randomized trials to corroborate their findings.
Neurology 2007;68:420-426.
