Perioperative complications of self-expanding stent angioplasty for basilar atherosclerotic stenosis / 介入放射学杂志

ABSTRACT

Objective To discuss the perioperative complications of self-expanding Wingspan stent angioplasty for symptomatic basilar atherosclerotic stenosis.Methods A total of 91 consecutive patients with severe basilar atherosclerotic stenosis, who were admitted to the Interventional Radiology Department of Zhengzhou University People’s Hospital during the period from July 2007 to April 2013 to receive Wingspan stent angioplasty, were included in this study.The clinical data were retrospectively analyzed.Based on the operator’s experience, 30 patients who received treatment in the early stage of the period were defined as group A, 30 patients who received treatment in the middle stage of the period were defined as group B, and 31 patients who received treatment in the recent stage of the period were defined as group C.The incidence of perioperative complications, the risk factors and the prevention measures were analyzed.Results Wingspan stent angioplasty was successfully accomplished in all patients.The mean basilar atherosclerotic stenosis ratio was reduced from preoperative (82.2±5.8)%to postoperative (15.9±5.7)%.During the perioperative period of 30 days, strokes occurred in 13 patients (14.3%, 13/91), including perforating branch strokes in 8 patients (8.8%, 8/91); thrombosis occurred in 4 patients (4.4%, 4/91) and subarachnoid hemorrhage in 1 patient (1.1%, 1/91).Lethal and disabling stroke was seen in 2 patients (2.2%, 2/91), resulting in death (n=1) and severe disability (n=1).No other non-stroke-related complications occurred.Statistical analysis indicated that the incidence of ischemic strokes bore a parallel correlation with the following factors involvement of the middle segment of basilar artery (P=0.049), the longer affected arterial segment (P=0.002) and severe degree of stenosis(P=0.001); while the incidence of ischemic strokes showed no definite correlation with the operator’s experience (P=1.000).Conclusion In treating symptomatic severe basilar atherosclerotic stenosis, self-expanding Wingspan stent angioplasty carries a relatively higher incidence of perioperative complications.Patients with the middle segment stenosis of basilar artery and severe longer segmental stenosis are more prone to develop complications, but the incidence of lethal and disabling stroke is rather lower.