Objective:
To compare inpatient mortality rates in patients who underwent intracranial endovascular stenting and/or angioplasty of the vertebral artery or basilar artery by analyzing data from the National inpatient sample database (2012-2015).
Methods:
We extracted data utilizing ICD-9 diagnosis codes for occlusion and stenosis of vertebral artery with or without stroke (433.20, 433.21) and occlusion and stenosis of basilar artery with or without stroke (433.00, 433.01). The cohort included total of 201 patients. Binary logistic regression and Chi-square tests were utilized for data analysis.
Results:
A total number of 201 patients underwent either intracranial angioplasty alone or stenting with or without angioplasty for either vertebral or basilar artery stenosis. Male patients were predominant (74%). The majority were 51 to 75 years of age (76.1%). 55% of the patients had stenosis of the basilar artery, 45% had vertebral artery stenosis. The majority of patients underwent stenting with or without angioplasty (69%); 47% had basilar stenting and 53% had vertebral stenting. The common co-morbidities observed were hypertension (84%), diabetes mellitus (37%), peripheral vascular disease (20%) and obesity (14%). The overall mortality rate in this cohort was 17.4%. The mortality rate was significantly higher in patients with basilar artery stenosis when compared with vertebral artery stenosis regardless of type of procedure performed (24% vs 9%, P = 0.004). The mortality during hospitalization was not significantly affected by the type of procedure (angioplasty vs stenting with or without angioplasty), or by the aforementioned comorbidities. The significant predictor of mortality was basilar artery stenosis (OR 2.87, 95% CI 1.18-6.98, P =0.02).
Conclusion:
The overall mortality in this cohort of patients who underwent angioplasty vs stenting with or without angioplasty for basilar or vertebral intracranial artery stenosis was 17.4%. Mortality rate was significantly higher in patients with basilar artery stenosis (24%) compared to those with vertebral artery stenosis (9%). The type of procedure performed (angioplasty vs stenting with or without angioplasty) had no significant statistical impact.
