Peri-procedural stroke or death in stenting of symptomatic severe intracranial stenosis

Research output: Contribution to journalArticle

Authors

  • Shadi Yaghi
  • Pooja Khatri
  • Adam De Havenon
  • Sharon Yeatts
  • Andrew D. Chang
  • Shawna Cutting
  • Brian Mac Grory
  • Tina Burton
  • Mahesh V. Jayaraman
  • Ryan A. McTaggart
  • David Fiorella
  • Colin Derdeyn
  • Osama O. Zaidat
  • Seena Dehkharghani
  • Sepideh Amin-Hanjani
  • Karen Furie
  • Shyam Prahbakaran
  • David Liebeskind

External Institution(s)

  • University of Cincinnati
  • Medical University of South Carolina
  • Brown University
  • Cleveland Clinic Florida
  • Cleveland Clinic Foundation
  • Stony Brook University
  • University of Iowa
  • St Vincent Mercy Hospital
  • New York University
  • University of Illinois at Chicago
  • Rhode Island Hospital
  • The University of Chicago
  • University of California at Los Angeles

Details

Original languageEnglish (US)
Pages (from-to)374-379
Number of pages6
JournalJournal of neurointerventional surgery
Volume12
Issue number4
StatusPublished - Apr 1 2020
Peer-reviewedYes

Abstract

Background and purpose There are limited data on predictors of 30-day stroke or death in patients with symptomatic intracranial atherosclerosis (sICAS) undergoing stenting. We aim to determine the factors associated with stroke or death at 30 days in the stenting arm of the SAMMPRIS trial. Methods This is a post-hoc analysis of the SAMMPRIS trial including patients who underwent angioplasty/stenting. We compared patient-specific variables, lesion-specific variables, procedure-specific variables, and FDA-approved indications between patients with and without the primary outcome (stroke or death at 30 days). Logistic regression analyses were performed to evaluate associations with the primary outcome. Results We identified 213 patients, 30 of whom (14.1%) met the primary outcome. Smoking status and lesion length were associated with the primary outcome: the odds of stroke or death for non-smokers versus smokers (adjusted OR 4.46, 95% CI 1.79 to 11.1, p=0.001) and for increasing lesion length in millimeters (adjusted OR 1.20, 95% CI 1.02 to 1.39, p=0.029). These had a modest predictive value: absence of smoking history (sensitivity 66.7%, specificity 65.4%) and lesion length (area under curve 0.606). Furthermore, event rates were not significantly different between patients with and without the FDA-approved indication for stenting (15.9% vs 12%, p=0.437). Conclusion In SAMMPRIS patients who underwent angioplasty/stenting, neither clinical and neuroimaging variables nor the FDA indication for stenting reliably predicted the primary outcome. Further work in identifying reliable biomarkers of stroke/death in patients with sICAS is needed before considering new clinical trials of stenting. Trial registration number SAMMPRIS NCT00576693; Results.

    Research areas

  • angioplasty, atherosclerosis, stent, stroke

Citation formats

APA

Yaghi, S., Khatri, P., De Havenon, A., Yeatts, S., Chang, A. D., Cutting, S., ... Liebeskind, D. (2020). Peri-procedural stroke or death in stenting of symptomatic severe intracranial stenosis. Journal of neurointerventional surgery, 12(4), 374-379. https://doi.org/10.1136/neurintsurg-2019-015225

Harvard

Yaghi, S, Khatri, P, De Havenon, A, Yeatts, S, Chang, AD, Cutting, S, Mac Grory, B, Burton, T, Jayaraman, MV, McTaggart, RA, Fiorella, D, Derdeyn, C, Zaidat, OO, Dehkharghani, S, Amin-Hanjani, S, Furie, K, Prahbakaran, S & Liebeskind, D 2020, 'Peri-procedural stroke or death in stenting of symptomatic severe intracranial stenosis', Journal of neurointerventional surgery, vol. 12, no. 4, pp. 374-379. https://doi.org/10.1136/neurintsurg-2019-015225