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Transluminal angioplasty and stenting versus conservative treatment in patients with symptomatic basilar artery stenosis: Perspective for future clinical trials

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Transluminal angioplasty and stenting versus conservative treatment in patients with symptomatic basilar artery stenosis: Perspective for future clinical trials. / Maier, Ilko L; Karch, André; Lipke, Christina; Behme, Daniel; Mpotsaris, Anastasios; Kabbasch, Christoph; Liebig, Thomas; Faymonville, Andrea; Reich, Arno; Nikoubashman, Omid; Buhk, Jan-Hendrik; von Schoenfeld, Patrick; Weber, Werner; Mikolajczyk, Rafael T; Bähr, Mathias; Knauth, Michael; Kallenberg, Kai; Liman, Jan.

in: CLIN NEURORADIOL, Jahrgang 28, Nr. 1, 03.2018, S. 33-38.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Maier, IL, Karch, A, Lipke, C, Behme, D, Mpotsaris, A, Kabbasch, C, Liebig, T, Faymonville, A, Reich, A, Nikoubashman, O, Buhk, J-H, von Schoenfeld, P, Weber, W, Mikolajczyk, RT, Bähr, M, Knauth, M, Kallenberg, K & Liman, J 2018, 'Transluminal angioplasty and stenting versus conservative treatment in patients with symptomatic basilar artery stenosis: Perspective for future clinical trials', CLIN NEURORADIOL, Jg. 28, Nr. 1, S. 33-38. https://doi.org/10.1007/s00062-016-0528-x

APA

Maier, I. L., Karch, A., Lipke, C., Behme, D., Mpotsaris, A., Kabbasch, C., Liebig, T., Faymonville, A., Reich, A., Nikoubashman, O., Buhk, J-H., von Schoenfeld, P., Weber, W., Mikolajczyk, R. T., Bähr, M., Knauth, M., Kallenberg, K., & Liman, J. (2018). Transluminal angioplasty and stenting versus conservative treatment in patients with symptomatic basilar artery stenosis: Perspective for future clinical trials. CLIN NEURORADIOL, 28(1), 33-38. https://doi.org/10.1007/s00062-016-0528-x

Vancouver

Maier IL, Karch A, Lipke C, Behme D, Mpotsaris A, Kabbasch C et al. Transluminal angioplasty and stenting versus conservative treatment in patients with symptomatic basilar artery stenosis: Perspective for future clinical trials. CLIN NEURORADIOL. 2018 Mär;28(1):33-38. https://doi.org/10.1007/s00062-016-0528-x

Bibtex

@article{ef77cc7ab37147839681e54cf1b8b52d,
title = "Transluminal angioplasty and stenting versus conservative treatment in patients with symptomatic basilar artery stenosis: Perspective for future clinical trials",
abstract = "PURPOSE: Two recent randomized controlled trials (RCT) consistently showed superiority of aggressive medical treatment versus percutaneous transluminal angioplasty and stenting (PTAS) in patients with intracranial artery stenosis. Patients with symptomatic basilar stenosis have a higher long-term risk of recurrent stroke compared to patients with anterior circulation stenosis but no study has specifically focused on the role of PTAS in this subgroup. The aim of our study was to investigate the subgroup of patients with symptomatic basilar artery stenosis to find evidence for the feasibility of a future clinical trial.METHODS: Patients with ischemic stroke caused by a symptomatic basilar stenosis and admitted to five German tertiary care hospitals were included in this multicenter effectiveness study. Primary outcome was a composite endpoint of stroke recurrence, clinically relevant restenosis, progression and death. Shared frailty Cox regression models were used to compare outcome rates between groups.RESULTS: Of the 139 patients included in the study 79 (57 %) underwent PTAS and 60 (43 %) conservative treatment alone. The median follow-up period was 300 (IQR 18-738) days. Risks of the primary composite outcome (hazard ratio HR 0.49, 95 % confidence interval CI 0.25-0.97, p = 0.039) and of the key secondary outcomes recurrent stroke (HR 0.42, 95 % CI 0.19-0.95, p = 0.037) and clinically relevant restenosis/progression (HR 0.12, 95 % CI 0.03-0.59, p = 0.009) were lower in patients with PTAS compared to conservative treatment. There was no difference in all-cause mortality between groups (HR 0.98, 95 % CI 0.19-5.09, p = 0.979).CONCLUSION: In this retrospective study we could not reproduce the findings from large RCTs on intracranial stenting. Our data could be considered as a basis for a prospective study on patient selection for PTAS in the basilar artery.",
author = "Maier, {Ilko L} and Andr{\'e} Karch and Christina Lipke and Daniel Behme and Anastasios Mpotsaris and Christoph Kabbasch and Thomas Liebig and Andrea Faymonville and Arno Reich and Omid Nikoubashman and Jan-Hendrik Buhk and {von Schoenfeld}, Patrick and Werner Weber and Mikolajczyk, {Rafael T} and Mathias B{\"a}hr and Michael Knauth and Kai Kallenberg and Jan Liman",
year = "2018",
month = mar,
doi = "10.1007/s00062-016-0528-x",
language = "English",
volume = "28",
pages = "33--38",
journal = "CLIN NEURORADIOL",
issn = "1869-1439",
publisher = "Springer Heidelberg",
number = "1",

}

RIS

TY - JOUR

T1 - Transluminal angioplasty and stenting versus conservative treatment in patients with symptomatic basilar artery stenosis: Perspective for future clinical trials

AU - Maier, Ilko L

AU - Karch, André

AU - Lipke, Christina

AU - Behme, Daniel

AU - Mpotsaris, Anastasios

AU - Kabbasch, Christoph

AU - Liebig, Thomas

AU - Faymonville, Andrea

AU - Reich, Arno

AU - Nikoubashman, Omid

AU - Buhk, Jan-Hendrik

AU - von Schoenfeld, Patrick

AU - Weber, Werner

AU - Mikolajczyk, Rafael T

AU - Bähr, Mathias

AU - Knauth, Michael

AU - Kallenberg, Kai

AU - Liman, Jan

PY - 2018/3

Y1 - 2018/3

N2 - PURPOSE: Two recent randomized controlled trials (RCT) consistently showed superiority of aggressive medical treatment versus percutaneous transluminal angioplasty and stenting (PTAS) in patients with intracranial artery stenosis. Patients with symptomatic basilar stenosis have a higher long-term risk of recurrent stroke compared to patients with anterior circulation stenosis but no study has specifically focused on the role of PTAS in this subgroup. The aim of our study was to investigate the subgroup of patients with symptomatic basilar artery stenosis to find evidence for the feasibility of a future clinical trial.METHODS: Patients with ischemic stroke caused by a symptomatic basilar stenosis and admitted to five German tertiary care hospitals were included in this multicenter effectiveness study. Primary outcome was a composite endpoint of stroke recurrence, clinically relevant restenosis, progression and death. Shared frailty Cox regression models were used to compare outcome rates between groups.RESULTS: Of the 139 patients included in the study 79 (57 %) underwent PTAS and 60 (43 %) conservative treatment alone. The median follow-up period was 300 (IQR 18-738) days. Risks of the primary composite outcome (hazard ratio HR 0.49, 95 % confidence interval CI 0.25-0.97, p = 0.039) and of the key secondary outcomes recurrent stroke (HR 0.42, 95 % CI 0.19-0.95, p = 0.037) and clinically relevant restenosis/progression (HR 0.12, 95 % CI 0.03-0.59, p = 0.009) were lower in patients with PTAS compared to conservative treatment. There was no difference in all-cause mortality between groups (HR 0.98, 95 % CI 0.19-5.09, p = 0.979).CONCLUSION: In this retrospective study we could not reproduce the findings from large RCTs on intracranial stenting. Our data could be considered as a basis for a prospective study on patient selection for PTAS in the basilar artery.

AB - PURPOSE: Two recent randomized controlled trials (RCT) consistently showed superiority of aggressive medical treatment versus percutaneous transluminal angioplasty and stenting (PTAS) in patients with intracranial artery stenosis. Patients with symptomatic basilar stenosis have a higher long-term risk of recurrent stroke compared to patients with anterior circulation stenosis but no study has specifically focused on the role of PTAS in this subgroup. The aim of our study was to investigate the subgroup of patients with symptomatic basilar artery stenosis to find evidence for the feasibility of a future clinical trial.METHODS: Patients with ischemic stroke caused by a symptomatic basilar stenosis and admitted to five German tertiary care hospitals were included in this multicenter effectiveness study. Primary outcome was a composite endpoint of stroke recurrence, clinically relevant restenosis, progression and death. Shared frailty Cox regression models were used to compare outcome rates between groups.RESULTS: Of the 139 patients included in the study 79 (57 %) underwent PTAS and 60 (43 %) conservative treatment alone. The median follow-up period was 300 (IQR 18-738) days. Risks of the primary composite outcome (hazard ratio HR 0.49, 95 % confidence interval CI 0.25-0.97, p = 0.039) and of the key secondary outcomes recurrent stroke (HR 0.42, 95 % CI 0.19-0.95, p = 0.037) and clinically relevant restenosis/progression (HR 0.12, 95 % CI 0.03-0.59, p = 0.009) were lower in patients with PTAS compared to conservative treatment. There was no difference in all-cause mortality between groups (HR 0.98, 95 % CI 0.19-5.09, p = 0.979).CONCLUSION: In this retrospective study we could not reproduce the findings from large RCTs on intracranial stenting. Our data could be considered as a basis for a prospective study on patient selection for PTAS in the basilar artery.

U2 - 10.1007/s00062-016-0528-x

DO - 10.1007/s00062-016-0528-x

M3 - SCORING: Journal article

C2 - 27506672

VL - 28

SP - 33

EP - 38

JO - CLIN NEURORADIOL

JF - CLIN NEURORADIOL

SN - 1869-1439

IS - 1

ER -