Impact of operator and site experience on outcomes after angioplasty and stenting in the SAMMPRIS trial

Colin P. Derdeyn, David Fiorella, Michael J. Lynn, Stanley L. Barnwell, Osama Zaidat, Philip M. Meyers, Y. Pierre Gobin, Jacques Dion, Bethany F. Lane, Tanya N. Turan, L. Scott Janis, Marc I. Chimowitz

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

Background and purpose To investigate the relationship between physician and site experience and the risk of 30 day hemorrhagic and ischemic strokes in the stenting arm of the Stenting and Aggressive Medical Management for the Prevention of Recurrent Ischemic Stroke (SAMMPRIS) trial. Methods Study records and an investigator survey were examined for physician and site related factors, including: number of Wingspan and aneurysm stents submitted for credentialing, number of study procedures performed in SAMMPRIS, years in practice after training, primary specialty, and site enrollment. Bivariate and multivariate analyses were performed to determine if these factors were associated with the 30 day rate of cerebrovascular events after angioplasty and stenting. Results 213 patients underwent angioplasty alone (n=5) or angioplasty and stenting (n=208) with study devices by 63 interventionists at 48 sites. For credentialing, the median number of Wingspan and similar aneurysm stent cases submitted by study interventionists were 10 and 6, respectively. Interventionists with higher numbers (>10) of Wingspan cases submitted for credentialing tended to have higher rates of 30 day events (19.0% vs 9.9%) than those with 12 patients). Conclusions Interventionists credentialed with less Wingspan experience were not responsible for the high rate of periprocedural stroke in SAMMPRIS. Hemorrhagic stroke may be related to low enrollment in the trial but not previous Wingspan experience.

Original languageEnglish (US)
Pages (from-to)528-533
Number of pages6
JournalJournal of NeuroInterventional Surgery
Volume5
Issue number6
DOIs
Publication statusPublished - Nov 2013

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ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Derdeyn, C. P., Fiorella, D., Lynn, M. J., Barnwell, S. L., Zaidat, O., Meyers, P. M., ... Chimowitz, M. I. (2013). Impact of operator and site experience on outcomes after angioplasty and stenting in the SAMMPRIS trial. Journal of NeuroInterventional Surgery, 5(6), 528-533. https://doi.org/10.1136/neurintsurg-2012-010504