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Peri-procedural stroke or death in stenting of symptomatic severe intracranial stenosis.

Publication ,  Journal Article
Yaghi, S; Khatri, P; de Havenon, A; Yeatts, S; Chang, AD; Cutting, S; Mac Grory, B; Burton, T; Jayaraman, MV; McTaggart, RA; Fiorella, D ...
Published in: J Neurointerv Surg
April 2020

BACKGROUND AND PURPOSE: There are limited data on predictors of 30-day stroke or death in patients with symptomatic intracranial atherosclerosis (sICAS) undergoing stenting. We aim to determine the factors associated with stroke or death at 30 days in the stenting arm of the SAMMPRIS trial. METHODS: This is a post-hoc analysis of the SAMMPRIS trial including patients who underwent angioplasty/stenting. We compared patient-specific variables, lesion-specific variables, procedure-specific variables, and FDA-approved indications between patients with and without the primary outcome (stroke or death at 30 days). Logistic regression analyses were performed to evaluate associations with the primary outcome. RESULTS: We identified 213 patients, 30 of whom (14.1%) met the primary outcome. Smoking status and lesion length were associated with the primary outcome: the odds of stroke or death for non-smokers versus smokers (adjusted OR 4.46, 95% CI 1.79 to 11.1, p=0.001) and for increasing lesion length in millimeters (adjusted OR 1.20, 95% CI 1.02 to 1.39, p=0.029). These had a modest predictive value: absence of smoking history (sensitivity 66.7%, specificity 65.4%) and lesion length (area under curve 0.606). Furthermore, event rates were not significantly different between patients with and without the FDA-approved indication for stenting (15.9% vs 12%, p=0.437). CONCLUSION: In SAMMPRIS patients who underwent angioplasty/stenting, neither clinical and neuroimaging variables nor the FDA indication for stenting reliably predicted the primary outcome. Further work in identifying reliable biomarkers of stroke/death in patients with sICAS is needed before considering new clinical trials of stenting. TRIAL REGISTRATION NUMBER: SAMMPRIS NCT00576693; Results.

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Published In

J Neurointerv Surg

DOI

EISSN

1759-8486

Publication Date

April 2020

Volume

12

Issue

4

Start / End Page

374 / 379

Location

England

Related Subject Headings

  • Stroke
  • Stents
  • Severity of Illness Index
  • Risk Factors
  • Postoperative Complications
  • Mortality
  • Middle Aged
  • Male
  • Intracranial Arteriosclerosis
  • Humans
 

Citation

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Chicago
ICMJE
MLA
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Yaghi, S., Khatri, P., de Havenon, A., Yeatts, S., Chang, A. D., Cutting, S., … Liebeskind, D. (2020). Peri-procedural stroke or death in stenting of symptomatic severe intracranial stenosis. J Neurointerv Surg, 12(4), 374–379. https://doi.org/10.1136/neurintsurg-2019-015225
Yaghi, Shadi, Pooja Khatri, Adam de Havenon, Sharon Yeatts, Andrew D. Chang, Shawna Cutting, Brian Mac Grory, et al. “Peri-procedural stroke or death in stenting of symptomatic severe intracranial stenosis.J Neurointerv Surg 12, no. 4 (April 2020): 374–79. https://doi.org/10.1136/neurintsurg-2019-015225.
Yaghi S, Khatri P, de Havenon A, Yeatts S, Chang AD, Cutting S, et al. Peri-procedural stroke or death in stenting of symptomatic severe intracranial stenosis. J Neurointerv Surg. 2020 Apr;12(4):374–9.
Yaghi, Shadi, et al. “Peri-procedural stroke or death in stenting of symptomatic severe intracranial stenosis.J Neurointerv Surg, vol. 12, no. 4, Apr. 2020, pp. 374–79. Pubmed, doi:10.1136/neurintsurg-2019-015225.
Yaghi S, Khatri P, de Havenon A, Yeatts S, Chang AD, Cutting S, Mac Grory B, Burton T, Jayaraman MV, McTaggart RA, Fiorella D, Derdeyn C, Zaidat OO, Dehkharghani S, Amin-Hanjani S, Furie K, Prahbakaran S, Liebeskind D. Peri-procedural stroke or death in stenting of symptomatic severe intracranial stenosis. J Neurointerv Surg. 2020 Apr;12(4):374–379.

Published In

J Neurointerv Surg

DOI

EISSN

1759-8486

Publication Date

April 2020

Volume

12

Issue

4

Start / End Page

374 / 379

Location

England

Related Subject Headings

  • Stroke
  • Stents
  • Severity of Illness Index
  • Risk Factors
  • Postoperative Complications
  • Mortality
  • Middle Aged
  • Male
  • Intracranial Arteriosclerosis
  • Humans