Article Figures & Data
Figures
- Figure 1
Study profile. BA, basilar artery; CASSISS, China Angioplasty and Stenting for Symptomatic Intracranial Severe Stenosis; ICA, internal carotid artery; MCA, middle cerebral artery; PTAS, percutaneous transluminal angioplasty and stenting; SAMMPRIS, Stenting vs Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis; VA, vertebral artery.
- Figure 2
Subgroup analysis for the primary outcome of BA stenosis. BA, basilar artery; PTAS, percutaneous transluminal angioplasty and stenting; TIA, transient ischaemic attack.
- Figure 3
Kaplan-Meier curves for the cumulative probability of the primary outcome in different qualifying arteries. The shading indicates 95%CI of the primary outcome. BA, basilar artery; ICA, internal carotid artery; MCA, middle cerebral artery; PTAS, percutaneous transluminal angioplasty and stenting; VA, vertebral artery.
Tables
- Table 1
Baseline characteristics of study participants
Categories PTAS group (n=400) Medical group (n=409) P value Age 59.31 (10.35) 58.09 (11.09) 0.11 Sex Male 255 (63.75%) 280 (68.46%) 0.16 Female 145 (36.25%) 129 (31.54%) Ethnicity origin Black 55 (13.75%) 49 (11.98%) 0.55 White 160 (40.00%) 162 (39.61%) Yellow 180 (45.00%) 188 (45.97%) Other 5 (1.25%) 10 (2.44%) Medical history Body mass index 28.72 (5.73 28.30 (5.60 0.31 Hypertension 317 (79.25%) 328 (80.20%) 0.79 Diabetes 162 (52.43%) 147 (47.57%) 0.19 Coronary artery disease 66 (16.50%) 78 (19.07%) 0.36 Lipid disorder 213 (53.25%) 223 (54.52%) 0.72 Peripheral artery disease 9 (2.25%) 15 (3.67%) 0.30 Received antiplatelet therapy prior to latest qualifying event 193 (48.25%) 188 (45.97%) 0.53 Smoking history Former 118 (29.50%) 118 (28.85%) 0.21 Current 95 (23.75%) 119 (29.10%) never 186 (46.50%) 172 (42.05%) Time from latest ischaemic event to randomisation, day 30.81 (41.58 33.71 (46.23 0.35 Qualifying event TIA 169 (42.25%) 152 (37.16%) 0.15 Stroke 231 (57.75%) 257 (62.84%) Stenosis rate of symptomatic qualifying artery % stenosis 79.74 (6.25) 79.23 (6.39) 0.25 Symptomatic qualifying artery ICA 60 (15.00%) 66 (16.14%) 0.05 MCA 157 (39.25%) 184 (44.99%) VA 84 (21.00%) 56 (13.69%) BA 99 (24.75%) 103 (25.18%) Distribution, % stenosis 70–79 213 (53.25%) 232 (56.72%) 0.45 80–89 157 (39.25%) 143 (34.96%) 90–99 30 (7.50%) 34 (8.31%) mRS score 0.88 (0.95) 0.90 (0.96 0.74 NIHSS score 1.15 (1.86) 1.08 (1.75) 0.58 LDL-C (mmol/L%) 2.34 (1.08) 2.35 (2.44) HDL-C (mmol/L%) 1.67 (0.69) 1.69 (0.69) 0.56 Data are mean±SD, n (%)
BA, basilar artery; HDL-C, high-density lipoprotein cholesterol; ICA, internal carotid artery; LDL-C, low-density lipoprotein cholesterol; MCA, middle cerebral artery; mRS, modified Rankin scale; NIHSS, National Institutes of Health Stroke Scale; PTAS, percutaneous transluminal angioplasty and stenting; TIA, transient ischaemic attack; VA, vertebral artery.
- Table 2
Primary and secondary outcomes in different stenosis locations
Categories ICA (n=126) Incidence difference (95% CI) HR (95% CI) P value MCA (n=341) Incidence difference (95% CI) HR (95% CI) P value VA (n=140) Incidence difference (95% CI) HR (95% CI) P value BA (n=202) Incidence difference (95% CI) HR(95% CI) P value PTAS group (n=60) Medical group (n=66) PTAS group (n=157) Medical group (n=184) PTAS group (n=84) Medical group (n=56) PTAS group (n=99) Medical group (n=103) Components of the primary outcome 16 (26.67%) 11 (16.67%) 10.00 (−4.50 to 24.49) 1.68 (0.78 to 3.62) 0.19 13 (8.28%) 18 (9.78%) −1.50 (−7.66 to 4.66) 0.85 (0.42 to 1.74) 0.66 8 (9.52%) 6 (10.71%) −1.19 (−11.50 to 9.12) 0.91 (0.32 to 2.62) 0.86 17 (17.17%) 8 (7.77%) 9.40 (0.31 to 2.04) 2.38 (1.03 to 5.52) 0.04 Stroke or death within 30 days after enrolment 9 (15.00%) 6 (9.09%) 8 (5.10%) 7 (3.80) 6 (7.14%) 1 (1.79%) 13 (13.13%) 3 (2.91%) Stroke in territory of qualifying artery beyond 30 days through 1 year 7 (11.67%) 5 (7.58%) 5 (3.18%) 11 (5.98) 2 (2.38%) 5 (8.93%) 4 (4.04%) 5 (4.85%) Secondary outcomes Stroke in the same territory within 2 years 17 (28.33%) 11 (16.67%) 11.67 (−2.98 to 26.32) 1.78 (0.83 to 3.84) 0.14 12 (7.64%) 21 (11.41%) −3.77 (−10.09 to 2.55) 0.70 (0.34 to 1.44) 0.33 9 (10.71%) 6 (10.71%) 0.00 (-10.63 to 10.63) 1.07 (0.35 to 3.26) 0.91 17 (17.17%) 8 (7.77%) 9.40 (0.31 to 18.50) 2.39 (1.03 to 5.55) 0.04 Stroke in the same territory within 3 years 17 (28.33%) 12 (18.18%) 10.15 (−4.72 to 25.02) 1.64 (0.77 to 3.46) 0.20 15 (9.55%) 22 (11.96%) −2.40 (−9.06 to 4.26) 0.84 (0.43 to 1.62) 0.60 10 (11.90%) 6 (10.71%) 1.19 (−9.74 to 12.12) 1.20 (0.40 to 3.58) 0.75 18 (18.18%) 8 (7.77%) 10.41 (1.19 to 19.64) 2.54 (1.10 to 5.84) 0.03 Disabling stroke or death within 3 years 13 (21.67%) 9 (13.64%) 8.03 (5.41 to 21.47) 1.65 (0.71 to 3.87) 0.25 6 (3.82%) 14 (7.61%) −3.79 (−8.81 to 1.23) 0.50 (0.19 to 1.30) 0.15 9 (10.71%) 4 (7.14%) 3.70 (−6.31 to 13.71) 1.55 (0.48 to 5.03) 0.47 12 (12.12%) 5 (4.85%) 7.27 (−0.41 to 14.94) 2.66 (0.94 to 7.55) 0.07 Death within 3 years 6 (10.33%) 3 (4.55%) 5.46 (−3.66 to 14.57) 2.27 (0.57 to 9.06) 0.25 5 (3.18%) 5 (2.72%) 0.47 (−3.15 to 4.08) 1.19 (0.34 to 4.09) 0.79 6 (7.14%) 2 (3.57%) 3.57 (−4.38 to 11.52) 2.06 (0.42 to 10.23) 0.38 1 (1.01%) 3 (2.91%) −1.90 (−5.78 to 1.97) 0.34 (0.04 to 3.30) 0.36 Any stroke within 3 years 18 (30.00%) 14 (21.21%) 8.79 (−6.62 to 24.2) 1.49 (0.74 to 2.99) 0.27 17 (10.83%) 22 (11.96%) −1.13 (−7.95 to 5.69) 0.90 (0.48 to 1.69) 0.73 8 (9.52%) 6 (10.71%) −1.19 (−11.50 to 9.12) 0.90 (0.31 to 2.59) 0.84 19 (19.19%) 10 (9.71%) 9.48 (−0.21 to 19.17) 2.14 (0.99 to 4.60) 0.05 Myocardial infarction within 3 years 4 (6.67%) 4 (6.06%) 0.61 (−8.07 to 9.28) 1.11 (0.28 to 4.43) 0.89 1 (0.64%) 4 (2.17%) −1.54 (−4.11 to 1.03) 0.29 (0.03 to 2.61) 0.27 3 (3.57%) 1 (1.79%) 1.79 (−3.93 to 7.50) 0.49 (0.05 to 4.76) 0.54 3 (3.03%) 4 (3.88%) −0.85 (−5.95 to 4.25) 0.78 (0.17 to 3.49) 0.75 Data are n (%), or median (IQR).
Boldface values indicate statistically significant differences
BA, basilar artery; ICA, internal carotid artery; MCA, middle cerebral artery; PTAS, percutaneous transluminal angioplasty and stenting; VA, vertebral artery.
- Table 3
Comparison of the primary outcome of different qualified arteries
Categories Number HR (95%) P value PTAS group Anterior circulation vs posterior circulation 29/217 (13.36%) vs 25/183 (13.66%) 1.04 (0.61 to 1.78) 0.87 MCA vs VA 13/157 (8.28%) vs 8/84 (4.76%) 0.87 (0.35 to 2.12) 0.75 MCA vs BA 13/157 (8.28%) vs 17/99 (17.17%) 2.17 (1.04 to 4.55) 0.03 MCA vs ICA 13/157 (8.28%) vs 16/60 (26.67%) 3.41 (1.49 to 7.77) <0.001 VA vs BA 8/84 (4.76%) vs 17/99 (17.17%) 1.88 (0.86 to 4.12) 0.13 VA vs ICA 8/84 (4.76%) vs 16/60 (26.67%) 2.97 (1.31 to 6.70) 0.008 BA vs ICA 17/99 (17.17%) vs 16/60 (26.67%) 1.53 (0.76 to 3.09) 0.22 Medical group Anterior circulation vs posterior circulation 29/250 (11.60%) vs 14/159 (8.81%) 0.75 (0.40 to 1.38) 0.37 MCA vs VA 18/184 (9.78%) vs 6/56 (10.71%) 1.10 (0.43 to 2.83) 0.84 MCA vs BA 18/184 (9.78%) vs 8/103 (7.77%) 0.79 (0.35 to 1.75) 0.57 MCA vs ICA 18/184 (9.78%) vs 11/66 (16.67%) 1.79 (0.78 to 4.13) 0.12 VA vs BA 6/56 (10.71%) vs 8/103 (7.77%) 0.72 (0.24 to 2.15) 0.53 VA vs ICA 6/56 (10.71%) vs 11/66 (16.67%) 1.64 (0.63 to 4.24) 0.33 BA vs ICA 8/103 (7.77%) vs 11/66 (16.67%) 2.26 (0.89 to 5.71) 0.07 Data are n (%), or median (IQR).
Boldface values indicate statistically significant differences.
BA, basilar artery; ICA, internal carotid artery; MCA, middle cerebral artery; PTAS, percutaneous transluminal angioplasty and stenting; VA, vertebral artery.
