A study of stents placement for symptomatic intracranial stenosis in patients with impaired regional cerebral blood flood

Objective To determine the patients with the impaired perfusion will probably maximize the benefit/risk ratio of this technique.Methods We analyzed retrospectively all endovascular procedures on symptomatic intracranial stenosis at our department from January 2007 to June 2008.We assigned patients to group A(hypoperfusion)or group B(normal perfusion).Primary outcome events were periprocedural major complications or recurrent ischemic strokes in the territory of the treated artery.Kaplan-Meier analysis was performed to determine the rate of major complications and recurrent strokes-free survival for a 1-year period.Results The procedural technical success rate was 91%(35/38)with periprocedural major complications in 2 cases,group A(8.3%,1/12),group B(9.1%,1/11).Median(range)follow-up for the 21 patients with technically successful procedures was 11.2 months.Recurrent ischemic strokes occurred in 0%(0/21)of patients in both group A and group B.Overall,there were 10%(2/21)primary outcome events,group A(8%,1/12),group B(11%,1/9).There was a no significant trend for better 1 year survival free of a major complication or recurrent stroke in patients with hypoperfusion compared with patients with normal perfusion,Kaplan-Meier estimate 0.92(SE 0.01) vs 0.89(SE 0.02) at 1 year respectively.Recurrent TIA perform dominant role in group B,imply patients with hypoperfusion associated with intracranial stenoses will probably maximize the benefit/risk ratio.Conclusion Patients with impaired perfusion may have greater benefit than those who with normal perfusion from intracranial stenting.