Study on the effect of location of intracranial arterial stenosis on the safety of stenting

Objective To investigate the effect of location of intracranial arterial stenosis on the safety of intracranial stenting. Methods A total of 73 patients with symptomatic intracranial atherosclerotic stenosis (ICAS) were divided into intracranial internal carotid artery (IICA, N = 18), middle cerebral artery (MCA)-M1 segment (MCA-M1, N = 11), intracranial vertebral artery (IVA, N = 27) and basilar artery (BA, N = 17). All of them underwent intracranial stenting. The improvement of intracranial arterial stenosis, cerebrovascular complications including perforating events, artery dissection, in-stent thrombosis, distal stent arterial embolism and cerebral hyperperfusion, and neurological complications including transient ischemic attack (TIA), ischemic stroke and intracranial hemorrhage were recorded. Modified Rankin Scale (mRS) was used to evaluate the prognosis 30 d after operation. Results A total of 73 stents were implanted in 73 patients (35 Apollo balloon-expandable stents and 38 Wingspan self-expandable stents). Among them, 10 cases (10/18) were treated with Apollo stents and 8 cases (8/18) with Wingspan stents in IICA group, 5 cases (5/11) were treated with Apollo stents and 6 cases (6/11) with Wingspan stents in MCA-M1 group, 16 cases (59.26%, 16/27) were treated with Apollo stents and 11 cases (40.74%, 11/27) with Wingspan stents in IVA group, and 4 cases (4/17) were treated with Apollo stents and 13 cases (13/17) with Wingspan stents in BA group. No significant difference was seen in stent type among 4 groups (χ2 = 7.422, P = 0.201). The stenosis rate of IICA group after treatment [(10.94 ± 1.99)%] was significantly improved than before treatment [(90.89 ± 7.71)%; t = 69.545, P = 0.000]. The stenosis rate of MCA-M1 group after treatment [(10.37 ± 2.14)%] was significantly improved than before treatment [(87.64 ± 9.46)%; t = 26.000, P = 0.000]. The stenosis rate of IVA group after treatment [(11.02 ± 1.99)% ] was significantly improved than before treatment [(89.11 ± 7.97)%; t = 50.726, P = 0.000]. The stenosis rate of BA group after treatment [(10.99 ± 3.39)%] was significantly improved than before treatment [(91.35 ± 5.62)%; t = 69.545, P = 0.000]. In 73 patients, cerebrovascular complications occurred in 11 cases (15.07%), including 4 cases of perforating events, 4 cases of artery dissection, one case of in-stent thrombosis and 2 cases of distal stent arterial embolism. There were 3 cases (3/18) in IICA group, including 2 cases of artery dissecti