Abstract TP142: Inpatient Mortality Rates in Endovascular Stenting and Angioplasty of Intracranial Vertebral and Basilar Arteries

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Abdallah Amireh ◽  
Okkes Kuybu ◽  
Oleg Chernyshev ◽  
Roger E Kelley ◽  
Vijayakumar Javalkar

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.

2014 ◽  
Vol 262 (2) ◽  
pp. 410-417 ◽  
Author(s):  
Annette Compter ◽  
◽  
Erik J. R. J. van der Hoeven ◽  
H. Bart van der Worp ◽  
Jan Albert Vos ◽  
...  

2006 ◽  
Vol 15 (7) ◽  
pp. 528-533
Author(s):  
Shingo Yamasaki ◽  
Kunio Hashimoto ◽  
Yoshihisa Kawano ◽  
Masataka Yoshimura ◽  
Takahiro Yamamoto ◽  
...  

2005 ◽  
Vol 46 (3) ◽  
pp. 314-321 ◽  
Author(s):  
S. H. Kim ◽  
J. S. Lee ◽  
O. K. Kwon ◽  
M. K. Han ◽  
J. H. Kim

Purpose: To evaluate the prevalence of proximal vertebral artery stenosis, compared with those of the distal vertebral/basilar artery and extracranial internal carotid artery, in a large population of stroke and non‐stroke patients. Material and Methods: Nine‐hundred‐and‐thirty‐five patients who underwent high‐resolution contrast‐enhanced magnetic resonance angiography in a regional general hospital were categorized into six groups based on neurological symptoms and disease: an asymptomatic group ( n = 182), a minor symptom group with headache or dizziness ( n = 519), a cardiac group with coronary artery steno‐occlusive disease ( n = 15), a hemorrhagic group with old cerebral hemorrhage ( n = 26), an anterior circulation infarct group ( n = 121), and posterior circulation infarct group ( n = 72). Prevalence of stenosis of the proximal vertebral artery, distal vertebral/basilar artery, and internal carotid artery was analyzed. Results: The prevalence of stenosis of the proximal vertebral artery, distal vertebral/basilar artery, and internal carotid artery was 12.9%, 5.5%, and 7.2%, respectively, in the study population, and rose as the age increased ( P<0.0001 for all arteries). The prevalence of stenosis of the proximal vertebral artery, distal vertebral/basilar artery, and internal carotid artery was 3.3%, 0.5%, and 1.1%, respectively, in the asymptomatic group; 8.3%, 2.1%, and 3.7%, respectively, in the minor symptom group; 13.3%, 6.7%, and 6.7%, respectively, in the cardiac group; 19.2%, 7.7%, and 7.7%, respectively, in the hemorrhagic group; 27.3%, 8.3%, and 25.6%, respectively, in the anterior circulation infarct group; and 44.4%, 36.1%, and 16.7%, respectively, in the posterior circulation infarct group. This increasing tendency of stenosis accordingly was statistically significant ( P<0.0001 for all arteries). Conclusion: The prevalence of proximal vertebral artery stenosis was highest, compared with those of the distal vertebral/basilar artery and internal carotid artery, although the clinical significance of proximal vertebral artery stenosis should be investigated in further studies.


Cureus ◽  
2017 ◽  
Author(s):  
Ali S Haider ◽  
Caleb Gottlich ◽  
Tijani Osumah ◽  
Maryam Alam ◽  
Umair Khan ◽  
...  

2014 ◽  
Vol 20 (6) ◽  
pp. 755-760 ◽  
Author(s):  
Jun Lu ◽  
Jiachun Liu ◽  
Daming Wang ◽  
Shuo Wang

Endovascular stenting with a balloon expandable device is currently the preferred treatment modality for symptomatic proximal vertebral artery stenosis, but high rates of in-stent restenosis remain a major problem, for which stent fracture might be a contributing factor. Limited reports showed that placement of self-expanding stents in the proximal vertebral artery might reduce restenosis; no stent fracture has been reported to date. We describe here a new case of fracture and occlusion of a self-expanding stent after endovascular treatment of symptomatic vertebral artery ostium stenosis.


2018 ◽  
Vol 12 (5) ◽  
pp. 247-253
Author(s):  
Kazuhiko Tokumura ◽  
Yoshiro Ito ◽  
Toshitsugu Terakado ◽  
Tomoji Takigawa ◽  
Aiki Marushima ◽  
...  

2015 ◽  
Vol 43 (1) ◽  
pp. 83-89 ◽  
Author(s):  
Madoka Okamura ◽  
◽  
Hidehiro Takekawa ◽  
Ryuta Okabe ◽  
Keisuke Suzuki ◽  
...  

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