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Stenting for symptomatic intracranial arterial stenosis in China:1-year outcome of a multicentre registry study

查看全文 作　　者：Ning [1]Ma;Yong [2]Zhang;Jie [3]Shuai;Changchun [4]Jiang;Qiyi [5]Zhu;Kangning [6]Chen;Li [7]Liu;Baomin [8]Li;Xiangqun [9]Shi;Lianbo [10]Gao;Yajie [11]Liu;Feng [12]Wang;Yongli [13]Li;Tieyan [14]Liu;Hongbo [15]Zheng;Dapeng [1]Mo;Feng [1]Gao;Yilong [16]Wang;Yongjun [16]Wang;Lei [17]Feng;Zhongrong [1]Miao 高影响力作者 机构地区：[1]Department of Interventional Neurology,Beijing Tiantan Hospital,Capital Medical University,China National Clinical Research Center for Neurological Diseases,Center of Stroke,Beijing Institute for Brain Disorders,Beijing,China;[2]Department of Neurology,The Affiliated Hospital of Qingdao University Medical College,Qingdao,China;[3]Department of Neurology,Xin Qiao Hospital,Third Military Medical University,Chongqing,China;[4]Department of Neurology,Baotou Central Hospital,Baotou,China;[5]Department of Neurology,Linyi People's Hospital,Linyi,China;[6]Department of Neurology,Xi Nan Hospital,Third Military Medical University,Chongqing,China;[7]Department of Neurology,The Hospital of Chifeng City,Chifeng,China;[8]Department of Neurosurgery,The PLA General Hospital,Beijing,China;[9]Department of Neurology,The Lanzhou General Hospital of PLA,Lanzhou,China;[10]Department of Neurology,The Affiliated Fourth Hospital of China Medical University,Shenyang,China;[11]Department of Neurology,Zhujiang Hospital,Southern Medical University,Guangzhou,China;[12]Department of Interventional Therapy,The First Affiliated Hospital of Dalian Medical University,Dalian,China;[13]Department of Neurosurgery,The Second Affiliated Hospital of Harbin Medical University,Harbin,China;[14]Department of Interventional Radiology,Cangzhou Central Hospital,Cangzhou,China;[15]Department of Neurology,West China Hospital,Sichuan University,Chengdu,China;[16]Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,China National Clinical Research Center for Neurological Diseases,Center of Stroke,Beijing Institute for Brain Disorders,Beijing,China;[17]Departments of Radiology,Kaiser Permanente Los Angeles Medical Center,Los Angeles,USA高影响力机构 出　　处：《Stroke & Vascular Neurology》索引2018年第3卷第3期,共9页高影响力期刊 基　　金：This work is supported by National Natural Science Foundation of China(81371290),Beijing High-level Personnel Funds(2013-2-019);This study is also funded by the National Science and Technology Support Program of‘The 12th Five-Year Plan’of the Ministry of Science and Technology(2011BAI08B02). 摘　　要：background and purpose A multicentre prospective registry study of individually tailored stenting for a patient with symptomatic intracranial atherosclerotic stenosis(ICAS)combined with poor collaterals in China showed that the short-term safety and efficacy of stenting was acceptable.However,it remained uncertain whether the low event rate could be of a long term.We reported the 1-year outcome of this registry study to evaluate the long-term efficacy of individually tailored stenting for patients with severe symptomatic ICAS combined with poor collaterals.Methods Patients with symptomatic ICAS caused by 70%-99% stenosis located at the intracranial internal carotid,middle cerebral,intracranial vertebral or basilar arteries combined with poor collaterals were enrolled.Balloon-mounted stent or balloon plus self-expanding stent were selected based on the ease of vascular access and lesion morphology determined by the operators.The primary outcome was the rate of 30-day stroke,transient ischaemic attack and death,and 12-month ischaemic stroke within the same vascular territory,haemorrhagic stroke and vascular death after stenting.results From September 2013 to January 2015,300 patients(ages 58.3±9.78 years)were recruited.Among them,159 patients were treated with balloon-mounted stent and 141 with balloon plus self-expanding stent.During the 1-year follow-up,25 patients had a primary end point event.The probability of primary outcome at 1 year was 8.1%(95% CI 5.3% to 11.7%).In 76 patients with digital subtraction angiography follow-up,27.6%(21/76)had re-stenosis≥50% and 18.4%(14/76)had re-stenosis≥70%.No baseline characteristic was associated with the primary outcome.Conclusion The event rate remains low over 1 year of individually tailored stenting for patients with severe symptomatic ICAS combined with poor collaterals.Further randomised trial of comparing individually tailored stenting with best medical therapy is needed. 关 键 词：STENOSIS BALLOON INTRACRANIAL
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