Predictors of Unfavorable Outcome in Intracranial Angioplasty and Stenting in a Single-Center Comparison: Results from the Borgess Medical Center-Intracranial Revascularization Registry

Article Figures & Data

Table 1:

Patient demographics, presentation, and vessel and lesion characteristics

	Angioplasty	Balloon-Mounted Stent	Wingspan Stent
Mean age (yr)	64.6	69.1	66.1
Male/female distribution by 159 lesions	26/29	31/8	37/28
Presentation
Mean days from first symptom to treatment	69.3	48.5	61.0
Mean presenting mRS	1.5	1.4	1.6
Mean stenosis before treatment of 159 primary lesions (%)	83	77	78
Transient ischemic attack (n = 61)	19	19	23
Minor stroke (change of 0–1 in mRS, n = 45)	20	9	16
Major stroke (change of ≥2 in mRS, n = 52)	15	11	26
Vessel and lesion characteristics for all 159 lesions
Lesions per device	55	39	65
<70% stenosis	2	4	7
≥70% stenosis	53	35	58
Perforators	32	13	47
Nonperforators	23	26	18
Smooth lesion	31	27	41
Irregular lesion	17	12	20
Concentric lesion	20	16	41
Eccentric lesion	28	23	20
Short lesion (<5 mm)	19	18	22
Moderate lesion (5–10 mm)	6	11	10
Long lesion (>10 mm)	23	10	29
Vessel and lesion characteristics for all 209 interventions
Interventions per device	89	47	73
<70% stenosis	9	5	8
≥70% stenosis	79	43	65
Perforators	51	14	54
Nonperforators	38	33	19
Smooth lesion	57	33	46
Irregular lesion	20	15	22
Concentric lesion	40	21	46
Eccentric lesion	37	27	22
Short lesion (<5 mm)	26	20	22
Moderate lesion (5–10 mm)	9	11	10
Long lesion (>10 mm)	42	17	36
Activating clotting time at deployment (s)	212	212	217
Duration of procedure (min)	163	149	154

Table 2:

Outcomes of intracranial revascularization by type of intervention

	All Interventions No. (%)	Angioplasty No. (%)	Angioplasty vs Balloon-Mounted Stent P Value	Balloon-Mounted Stent No. (%)	Balloon-Mounted Stent vs Wingspan P Value	Wingspan Stent No. (%)	Wingspan Stent vs Angioplasty P Value
Stroke at 30 days	27/209 (12.9)	4/89 (4.5)	.1721	5/47 (10.7)	.0579	18/73 (24.7)	.0002
Major	10/209 (4.8)	2/89 (2.25)		2/47 (4.3)		6/73 (8.3)
Minor	17/209 (8.1)	2/89 (2.25)		3/47 (6.4)		12/73 (16.4)
Stroke beyond 30 days	12/133 (9.0)	3/45 (6.7)	.3802	4/32 (12.5)	.5969	5/56 (8.9)	.6772
Success by intervention	159/209 (76.1)	52/89 (58.4)	.0039	39/48 (81.3)	.0233	68/72 (94.4)	<.0001
Restenosis	30/165 (18.2)	20/71 (28.2)	.0082	2/34 (5.8)	.2628	8/60 (13.3)	.0358
Device occlusion by intervention	10/189 (5.3)	4/83 (4.8)	.3657	4/45 (8.9)	.2188	2/61 (3.3)	.6487
Dissection by intervention	46/209 (22.0)	17/89 (19.1)	.7667	8/47 (17.0)	.1440	21/73 (28.8)	.1498

Table 3:

Incidence of stroke at 30 days by intervention and lesion location

	Total No. (%)	Angioplasty No. (%)	Balloon-Mounted Stent No. (%)	Wingspan Stent No. (%)
Vessel
ACA/MCA	13/80 (16.3)^a	3/44 (6.8)	0/1 (0)	10/35 (28.6)
ICA	2/41 (4.9)^a,^b	0/16 (0)	1/14 (7.1)	1/11 (9.1)
VA	4/48 (8.3)^c	1/21 (4.8)	1/19 (5.3)	2/8 (25.0)
BA	8/40 (20.0)^b	0/7 (0)	3/14 (21.4)	5/19 (26.3)
Circulation
Anterior	15/121 (12.4)	3/60 (5.0)	1/15 (6.7)	11/46 (23.9)
Posterior	12/88 (13.6)	1/28 (3.6)	4/33 (12.1)	7/27 (25.9)
Perforator status
Nonperforator (VA, ICA)	6/91 (6.6)^d	1/39 (2.6)	2/33 (6.1)	3/19 (15.8)
Perforator (BA, MCA)	21/118 (17.8)^d	3/49 (6.1)	3/15 (20.0)	15/54 (27.8)
Total	27/209 (12.9)	4/89 (4.5)	5/47 (10.7)	18/73 (24.7)

Table 4:

Influence of dissection and specific lesion morphology on incidence of stroke and restenosis

	Stroke within 30 Days for 209 Interventions No. (%)	Restenosis on 165 Follow-Up Angiograms for 209 Interventions No. (%)
Dissection	10/46 (22)	13/39 (33)
No dissection	17/163 (10)	17/126 (14)
Significant P value	.0439	.0051
Smooth/concentric/long lesions	4/43 (9)	17/30 (56.7)
All other morphology	23/166 (14)	13/135 (10)
Significant P value	NS	<.0001