Safety and efficacy of percutaneous transluminal angioplasty for intracranial atherosclerotic stenosis

Wayne Clark, Stanley L. Barnwell, Gary Nesbit, Oisin R. O’neill, Michael L. Wynn, Bruce M. Coull

Research output: Contribution to journalArticle

146 Citations (Scopus)

Abstract

Percutaneous transluminal angioplasty (PCTA) is increasingly used to treat extracerebral arterial stenosis. The present study evaluates the safety and efficacy of PCTA treatment of symptomatic intracranial atherosclerotic stenosis. Methods A series of 22 vessels in 17 patients were treated with PCTA. All patients had recurrent neurological symptoms referable to the stenotic vessel despite optimal medical therapy. Critical (more than 70%) arterial stenosis was confirmed by angiogram, and angioplasty was performed with a 3.0- to 3.5-mm Stealth balloon. Results The average preangioplasty stenosis (North American Symptomatic Carotid Endarterectomy Trial criteria) was 72 plus minus 8% (mean plus minus SD), with a significant improvement seen after angioplasty; the best angiographic stenosis (after healing of intimal injury, if any) was 43 plus minus 24% (P less than.001). Overall PCTA was successful in 82% of the vessels. There were two strokes during angioplasty for a 30-day morbidity rate of 9.1% per treated vessel and 11.7% per case. The other 15 patients were clinically evaluated at 3 and 6 months; all cases were without further events. Restenosis was evaluated in 8 patients (12 vessels) with an angiogram at 6 months showing further improvement compared with the initial post-PCTA stenosis (51 plus minus 10% versus 37 plus minus 21% [P equals.05]). Conclusions PCTA may be a beneficial therapy in selected cases of symptomatic intracranial atherosclerotic stenosis. Further study using a randomized trial is needed.

Original languageEnglish (US)
Pages (from-to)1200-1204
Number of pages5
JournalStroke
Volume26
Issue number7
StatePublished - 1995

Fingerprint

Angioplasty
Pathologic Constriction
Safety
Angiography
Tunica Intima
Carotid Endarterectomy
Therapeutics
Stroke
Morbidity
Wounds and Injuries

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing
  • Neuroscience(all)

Cite this

Clark, W., Barnwell, S. L., Nesbit, G., O’neill, O. R., Wynn, M. L., & Coull, B. M. (1995). Safety and efficacy of percutaneous transluminal angioplasty for intracranial atherosclerotic stenosis. Stroke, 26(7), 1200-1204.

Safety and efficacy of percutaneous transluminal angioplasty for intracranial atherosclerotic stenosis. / Clark, Wayne; Barnwell, Stanley L.; Nesbit, Gary; O’neill, Oisin R.; Wynn, Michael L.; Coull, Bruce M.

In: Stroke, Vol. 26, No. 7, 1995, p. 1200-1204.

Research output: Contribution to journalArticle

Clark, W, Barnwell, SL, Nesbit, G, O’neill, OR, Wynn, ML & Coull, BM 1995, 'Safety and efficacy of percutaneous transluminal angioplasty for intracranial atherosclerotic stenosis', Stroke, vol. 26, no. 7, pp. 1200-1204.
Clark W, Barnwell SL, Nesbit G, O’neill OR, Wynn ML, Coull BM. Safety and efficacy of percutaneous transluminal angioplasty for intracranial atherosclerotic stenosis. Stroke. 1995;26(7):1200-1204.
Clark, Wayne ; Barnwell, Stanley L. ; Nesbit, Gary ; O’neill, Oisin R. ; Wynn, Michael L. ; Coull, Bruce M. / Safety and efficacy of percutaneous transluminal angioplasty for intracranial atherosclerotic stenosis. In: Stroke. 1995 ; Vol. 26, No. 7. pp. 1200-1204.
@article{39596818fa824af29a54f06802807303,
title = "Safety and efficacy of percutaneous transluminal angioplasty for intracranial atherosclerotic stenosis",
abstract = "Percutaneous transluminal angioplasty (PCTA) is increasingly used to treat extracerebral arterial stenosis. The present study evaluates the safety and efficacy of PCTA treatment of symptomatic intracranial atherosclerotic stenosis. Methods A series of 22 vessels in 17 patients were treated with PCTA. All patients had recurrent neurological symptoms referable to the stenotic vessel despite optimal medical therapy. Critical (more than 70{\%}) arterial stenosis was confirmed by angiogram, and angioplasty was performed with a 3.0- to 3.5-mm Stealth balloon. Results The average preangioplasty stenosis (North American Symptomatic Carotid Endarterectomy Trial criteria) was 72 plus minus 8{\%} (mean plus minus SD), with a significant improvement seen after angioplasty; the best angiographic stenosis (after healing of intimal injury, if any) was 43 plus minus 24{\%} (P less than.001). Overall PCTA was successful in 82{\%} of the vessels. There were two strokes during angioplasty for a 30-day morbidity rate of 9.1{\%} per treated vessel and 11.7{\%} per case. The other 15 patients were clinically evaluated at 3 and 6 months; all cases were without further events. Restenosis was evaluated in 8 patients (12 vessels) with an angiogram at 6 months showing further improvement compared with the initial post-PCTA stenosis (51 plus minus 10{\%} versus 37 plus minus 21{\%} [P equals.05]). Conclusions PCTA may be a beneficial therapy in selected cases of symptomatic intracranial atherosclerotic stenosis. Further study using a randomized trial is needed.",
author = "Wayne Clark and Barnwell, {Stanley L.} and Gary Nesbit and O’neill, {Oisin R.} and Wynn, {Michael L.} and Coull, {Bruce M.}",
year = "1995",
language = "English (US)",
volume = "26",
pages = "1200--1204",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Safety and efficacy of percutaneous transluminal angioplasty for intracranial atherosclerotic stenosis

AU - Clark, Wayne

AU - Barnwell, Stanley L.

AU - Nesbit, Gary

AU - O’neill, Oisin R.

AU - Wynn, Michael L.

AU - Coull, Bruce M.

PY - 1995

Y1 - 1995

N2 - Percutaneous transluminal angioplasty (PCTA) is increasingly used to treat extracerebral arterial stenosis. The present study evaluates the safety and efficacy of PCTA treatment of symptomatic intracranial atherosclerotic stenosis. Methods A series of 22 vessels in 17 patients were treated with PCTA. All patients had recurrent neurological symptoms referable to the stenotic vessel despite optimal medical therapy. Critical (more than 70%) arterial stenosis was confirmed by angiogram, and angioplasty was performed with a 3.0- to 3.5-mm Stealth balloon. Results The average preangioplasty stenosis (North American Symptomatic Carotid Endarterectomy Trial criteria) was 72 plus minus 8% (mean plus minus SD), with a significant improvement seen after angioplasty; the best angiographic stenosis (after healing of intimal injury, if any) was 43 plus minus 24% (P less than.001). Overall PCTA was successful in 82% of the vessels. There were two strokes during angioplasty for a 30-day morbidity rate of 9.1% per treated vessel and 11.7% per case. The other 15 patients were clinically evaluated at 3 and 6 months; all cases were without further events. Restenosis was evaluated in 8 patients (12 vessels) with an angiogram at 6 months showing further improvement compared with the initial post-PCTA stenosis (51 plus minus 10% versus 37 plus minus 21% [P equals.05]). Conclusions PCTA may be a beneficial therapy in selected cases of symptomatic intracranial atherosclerotic stenosis. Further study using a randomized trial is needed.

AB - Percutaneous transluminal angioplasty (PCTA) is increasingly used to treat extracerebral arterial stenosis. The present study evaluates the safety and efficacy of PCTA treatment of symptomatic intracranial atherosclerotic stenosis. Methods A series of 22 vessels in 17 patients were treated with PCTA. All patients had recurrent neurological symptoms referable to the stenotic vessel despite optimal medical therapy. Critical (more than 70%) arterial stenosis was confirmed by angiogram, and angioplasty was performed with a 3.0- to 3.5-mm Stealth balloon. Results The average preangioplasty stenosis (North American Symptomatic Carotid Endarterectomy Trial criteria) was 72 plus minus 8% (mean plus minus SD), with a significant improvement seen after angioplasty; the best angiographic stenosis (after healing of intimal injury, if any) was 43 plus minus 24% (P less than.001). Overall PCTA was successful in 82% of the vessels. There were two strokes during angioplasty for a 30-day morbidity rate of 9.1% per treated vessel and 11.7% per case. The other 15 patients were clinically evaluated at 3 and 6 months; all cases were without further events. Restenosis was evaluated in 8 patients (12 vessels) with an angiogram at 6 months showing further improvement compared with the initial post-PCTA stenosis (51 plus minus 10% versus 37 plus minus 21% [P equals.05]). Conclusions PCTA may be a beneficial therapy in selected cases of symptomatic intracranial atherosclerotic stenosis. Further study using a randomized trial is needed.

UR - http://www.scopus.com/inward/record.url?scp=0029034161&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029034161&partnerID=8YFLogxK

M3 - Article

C2 - 7604414

AN - SCOPUS:0029034161

VL - 26

SP - 1200

EP - 1204

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 7

ER -