Key result
Residual stenosis >30% post-PTAS is linked to ~295% higher odds of ischemic events.
Why the study?
Does residual stenosis >30% following percutaneous transluminal angioplasty and stenting predict stroke recurrence and death in patients with symptomatic intracranial atherosclerotic stenosis?
Cohort (n=113)
No
Does residual stenosis >30% following percutaneous transluminal angioplasty and stenting predict stroke recurrence and death in patients with symptomatic intracranial atherosclerotic stenosis?
Odds Ratio: 3.95 (95% CI 1.01–15.38)
p-value: p=0.048
In patients with symptomatic intracranial atherosclerotic stenosis undergoing stenting, a residual stenosis rate >30% is an independent predictor of stroke recurrence at 1 year.
May flag higher-risk patients for closer monitoring after intracranial stenting; leaves open whether optimizing residual stenosis improves outcomes in trials.
Objective: The purpose of this study was to investigate the correlation between residual stenosis rate following percutaneous transluminal angioplasty and stenting (PTAS) and the incidence of ischemic stroke recurrence in patients with symptomatic intracranial atherosclerotic stenosis (sICAS) within 1-year postsurgery. Subjects and Methods: We retrospectively analyzed data from 113 patients with sICAS treated with PTAS between January 1, 2018 and March 31, 2022, at the Stroke Intervention and Translational Center in Beijing Luhe Hospital, Capital Medical University. Outcomes were included stroke and death after stenting within 1 year. Of the sample, 60 patients had middle cerebral artery (MCA) or basilar artery (BA) lesion, and 53 patients had internal carotid artery (ICA) or vertebral artery (VA) lesion. Logistic regression evaluated the association between residual stenosis rate and clinical outcomes. Results: The occurrence rate of perioperative endpoint events was 5.3%. The 3-month rate of endpoint event was 8.8%. A total of 16 endpoint events (14.2%) were observed within a 1-year timeframe. The residual stenosis rate >30% (odds ratio [OR] 3.95; 95% confidence interval [CI]: 1.01–15.38; P = 0.048) and MCA or BA lesion (OR 3.85; 95% CI 1.00–14.89; P = 0.050) independently correlated with ischemic events within 1 year. In the MCA+BA group, residual stenosis rate >30% was observed tended to increase the occurrence of ischemic events within 1 year (OR: 3.35; 95% CI: 0.86–13.10; P = 0.083) after accounting for other confounders. In the ICA+VA group, univariate analysis showed residual stenosis >30% was associated with ischemic events within 1 year ( P = 0.028), but no independent association was found after adjusting for other confounding factors. Conclusions: Residual stenosis rate >30% is an independent predictor of stroke recurrence at 1-year postendovascular therapy in patients with sICAS.
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Liu et al. (2024) conducted a cohort in symptomatic intracranial atherosclerotic stenosis (sICAS) (n=113). Residual stenosis rate >30% vs. Residual stenosis rate ≤30% was evaluated on Ischemic events within 1 year (OR 3.95, 95% CI 1.01-15.38, p=0.048). Residual stenosis >30% following percutaneous transluminal angioplasty and stenting was an independent predictor of ischemic events within 1 year (OR 3.95; 95% CI 1.01-15.38; P=0.048).
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