HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Correspondence: Submit a response Correspondence: View responses Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Jiang, W. J. Articles by Xu, X. T. Search for Related Content PubMed PubMed Citation Articles by Jiang, W. J. Articles by Xu, X. T. Related Collections Stroke prevention All Cerebrovascular disease/Stroke Infarction

Perforator stroke after elective stenting of symptomatic intracranial stenosis

From Interventional Neuroradiology (W.J.J., F.G., B.D.), the Neurovascular Angioplasty Team, Department of Neurology (T.S., K.H.D.), and Neuroradiology (X.T.X.), Beijing Tiantan Hospital, Capital University of Medical Sciences, Beijing, China.

Address correspondence and reprint requests to Dr. Wei-Jian Jiang, Department of Neurology and Interventional Neuroradiology, Beijing Tiantan Hospital, Capital University of Medical Sciences, No.6 Tiantan Xili, Beijing 100050, China; e-mail: cjr.jiangweijian{at}vip.163.com

Objective: To study the frequency, clinical course, and functional outcome of perforator stroke (PS) resulting from elective stenting of symptomatic intracranial stenosis.

Methods: Between September 2001 and November 2004, 169 consecutive patients with 181 symptomatic intracranial stenoses underwent stenting procedure at our institute. The preoperative perforator infarct adjacent to the stenotic segment (PIAS) on MRI was evaluated blindly. Patients who developed PS after stenting were enrolled. Each patient was assessed by an experienced stroke neurologist by neurologic examination and NIH Stroke Scale score every day until discharge and at day 30, and by modified Rankin Scale (mRS) score at the end of the first, third, and sixth month, and then at intervals of 6 months.

Results: PS frequency was 3.0% (5/169 patients). The patients with preoperative PIAS had a higher frequency of PS and PS exacerbation, resulting from intracranial stenting (8.2%, 4/49), vs patients without preoperative PIAS (0.8%, 1/120; p = 0.031). Four PSs occurred during the procedure and one 10 hours after stenting. Four PSs reached the maximum deficit almost at once, and one after 2 hours from onset. All five patients were functionally independent (mRS 1) within 12 months.

Conclusion: Patients with preoperative perforator infarct adjacent to the stenotic segment have a higher perforator stroke frequency after elective stenting of intracranial stenosis. Most perforator strokes occur during the procedure and reach the maximum deficit almost immediately. Functional outcomes are relatively good.

Editorial, see page 1803

Disclosure: The authors report no conflicts of interest.

Received December 5, 2005. Accepted in final form February 28, 2006.

This article has been cited by other articles:

				F. Nahab, M. J. Lynn, S. E. Kasner, M. J. Alexander, R. Klucznik, O. O. Zaidat, J. Chaloupka, H. Lutsep, S. Barnwell, M. Mawad, et al. Risk factors associated with major cerebrovascular complications after intracranial stenting Neurology, June 9, 2009; 72(23): 2014 - 2019. [Abstract] [Full Text] [PDF]

				K. Groschel, S. Schnaudigel, S. M. Pilgram, K. Wasser, and A. Kastrup A Systematic Review on Outcome After Stenting for Intracranial Atherosclerosis Stroke, May 1, 2009; 40(5): e340 - e347. [Abstract] [Full Text] [PDF]

				T. W. Leung, H. Mak, S. C.H. Yu, K.-s. Wong, W.-J. Jiang, and F. Gao Perforator stroke after elective stenting of symptomatic intracranial stenosis Neurology, April 10, 2007; 68(15): 1237 - 1237. [Full Text] [PDF]

				W.-J. Jiang, B. Du, T. W. Leung, X.-T. Xu, M. Jin, and K.-H. Dong Symptomatic Intracranial Stenosis: Cerebrovascular Complications from Elective Stent Placement Radiology, April 1, 2007; 243(1): 188 - 197. [Abstract] [Full Text] [PDF]

				W. J. Jiang, X. T. Xu, B. Du, K. H. Dong, M. Jin, Q. H. Wang, and N. Ma Long-term outcome of elective stenting for symptomatic intracranial vertebrobasilar stenosis Neurology, March 13, 2007; 68(11): 856 - 858. [Abstract] [Full Text] [PDF]

				W. J. Jiang, X. T. Xu, B. Du, K. H. Dong, M. Jin, Q. H. Wang, and N. Ma Comparison of elective stenting of severe vs moderate intracranial atherosclerotic stenosis Neurology, February 6, 2007; 68(6): 420 - 426. [Abstract] [Full Text] [PDF]

				D. M. Pelz, E. I. Levy, and L. N. Hopkins Advances in Interventional Neuroradiology 2006 Stroke, February 1, 2007; 38(2): 232 - 234. [Full Text] [PDF]

				E. I. Levy and S. Chaturvedi Perforator stroke following intracranial stenting: A sacrifice for the greater good? Neurology, June 27, 2006; 66(12): 1803 - 1804. [Full Text] [PDF]

Correspondence: