[Long-term outcome after endovascular treatment of high-risk patients with recurrently symptomatic intracranial stenoses of the posterior circulation]
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[Long-term outcome after endovascular treatment of high-risk patients with recurrently symptomatic intracranial stenoses of the posterior circulation]. / Wittkugel, Oliver; Rosenkranz, Michael; Burkhardt, Doreen; Niessen, W; Espersen, T; Zeumer, Hermann; Fiehler, Jens; Grzyska, Ulrich.
in: ROFO-FORTSCHR RONTG, 2009.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - [Long-term outcome after endovascular treatment of high-risk patients with recurrently symptomatic intracranial stenoses of the posterior circulation]
AU - Wittkugel, Oliver
AU - Rosenkranz, Michael
AU - Burkhardt, Doreen
AU - Niessen, W
AU - Espersen, T
AU - Zeumer, Hermann
AU - Fiehler, Jens
AU - Grzyska, Ulrich
PY - 2009
Y1 - 2009
N2 - PURPOSE: We present long-term clinical and duplex data from high-risk patients with severe, recurrent symptomatic stenoses of the vertebrobasilar circulation. We hypothesized that despite the greater risk of periprocedural complications in this patient group, interventional treatment would reduce the risk of recurrent strokes relative to the expected natural risk. We also predicted that the long-term treatment outcome would be positively influenced by the use of stents and by the periprocedural technical success rate. MATERIALS AND METHODS: An analysis of our patient data base yielded 45 cases of stenosis of the vertebrobasilar circulation treated endovascularly in 42 patients between 1998 and 2006. Clinical and vascular diagnostic tests, both periinterventionally and during follow-up, were performed independently by experienced neurologists. RESULTS: The technical success rate was 93%. Stents were used in 67% of the procedures. After 30 days, 24% of the patients showed post-procedural clinical deterioration. After an average period of 26.3 months, 17.8 % of the patients had deteriorated. 11.1% of the patients suffered severe permanent damage as a result of the procedure (mRs 3 - 6). Restenosis was found in 9.5% of the cases. There were no instances of a recurrent stroke during follow-up. CONCLUSION: For this population of high-risk patients with recurrently symptomatic intracranial stenoses of the vertebrobasilar axis, endovascular treatment reduced the risk of stroke and death relative to the expected natural risk. The use of stents had no significant effect on the long-term results.
AB - PURPOSE: We present long-term clinical and duplex data from high-risk patients with severe, recurrent symptomatic stenoses of the vertebrobasilar circulation. We hypothesized that despite the greater risk of periprocedural complications in this patient group, interventional treatment would reduce the risk of recurrent strokes relative to the expected natural risk. We also predicted that the long-term treatment outcome would be positively influenced by the use of stents and by the periprocedural technical success rate. MATERIALS AND METHODS: An analysis of our patient data base yielded 45 cases of stenosis of the vertebrobasilar circulation treated endovascularly in 42 patients between 1998 and 2006. Clinical and vascular diagnostic tests, both periinterventionally and during follow-up, were performed independently by experienced neurologists. RESULTS: The technical success rate was 93%. Stents were used in 67% of the procedures. After 30 days, 24% of the patients showed post-procedural clinical deterioration. After an average period of 26.3 months, 17.8 % of the patients had deteriorated. 11.1% of the patients suffered severe permanent damage as a result of the procedure (mRs 3 - 6). Restenosis was found in 9.5% of the cases. There were no instances of a recurrent stroke during follow-up. CONCLUSION: For this population of high-risk patients with recurrently symptomatic intracranial stenoses of the vertebrobasilar axis, endovascular treatment reduced the risk of stroke and death relative to the expected natural risk. The use of stents had no significant effect on the long-term results.
M3 - SCORING: Zeitschriftenaufsatz
JO - ROFO-FORTSCHR RONTG
JF - ROFO-FORTSCHR RONTG
SN - 1438-9029
ER -