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Open Access

Update in the treatment of intracranial atherosclerotic disease

Zachary R Barnard, Michael J Alexander
DOI: 10.1136/svn-2019-000279 Published 16 October 2019
Zachary R Barnard
Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
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Michael J Alexander
Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
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Article Figures & Data

Tables

  • Table 1

    Major Wingspan stent trials with mean time to treatment and complication rates

    PublicationPatients stented (n)Percentage stented on label for strokePeriprocedural complications %)Time to stent from stroke or TIA (days)
    HDE trialStroke, 20072444934.522
    US registryStroke, 200727
    Stroke, 201128
    158576.9Not reported
    NIH registryNeurology, 200825160616.210
    SAMMPRISNew England Journal of Medicine, 201182088.214.77
    JiangStroke, 201130100715.034
    MiaoStroke, 201529141564.319 for TIA/32 for stroke
    ZhaoJournal of Stroke and Cerebrovascular Diseases, 201633278Not reported4.321
    GaoAmerican Journal of Neuroradiology, 201635100502.021
    MaStroke and Vascular Neurology, 201834141564.022
    WEAVEStroke, 2019371521002.622
    • HDE, Humanitarian Device Exemption; NIH, National Institutes of Health; SAMMPRIS, Stenting vs Aggressive Medical Therapy for Intracranial Artery Stenosis; TIA, transient ischaemic attack; WEAVE, Wingspan Stent System Post Market Surveillance.

  • Table 2

    Comparisonsvn-2019 of 1-year stroke and death rates with medical therapy and stenting 21 days or longer after qualifying event

    Medical therapyPublicationPatients (n)One-year stroke and death rate (%)
    WASIDNew England Journal of Medicine, 2005756918
    SAMMPRISNew England Journal of Medicine, 2011822712.2
    COSSThe Journal of the American Medical Association, 201199816
    Total/mean event rate 89415.4
    Stenting 
    JiangStroke, 2011301007.3
    LiPloS One, 2015314299.5
    WangNeuroradiology, 2016321969.6
    ZhaoJournal of Stroke and Cerebrovascular Diseases, 2016332785.8
    MaStroke and Vascular Neurology, 2018341417.9
    Total/mean event rate 11348.0
    • COSS, Carotid Occlusion Surgery Study; SAMMPRIS, Stenting vs Aggressive Medical Therapy for Intracranial Artery Stenosis; WASID, Warfarin vs Aspirin for Symptomatic Intracranial Disease.

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Vol 10 Issue 1 Table of Contents
Stroke and Vascular Neurology: 10 (1)
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Update in the treatment of intracranial atherosclerotic disease
Zachary R Barnard, Michael J Alexander
Stroke and Vascular Neurology Oct 2019, svn-2019-000279; DOI: 10.1136/svn-2019-000279

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Update in the treatment of intracranial atherosclerotic disease
Zachary R Barnard, Michael J Alexander
Stroke and Vascular Neurology Oct 2019, svn-2019-000279; DOI: 10.1136/svn-2019-000279
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Update in the treatment of intracranial atherosclerotic disease
Zachary R Barnard, Michael J Alexander
Stroke and Vascular Neurology Oct 2019, svn-2019-000279; DOI: 10.1136/svn-2019-000279
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  • Article
    • Abstract
    • Introduction
    • Incidence
    • Diagnosis
    • Medical therapy
    • Surgical therapy
    • Endovascular therapy: balloon angioplasty
    • Endovascular therapy: intracranial stenting
    • Summary
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