Stenting versus medical treatment for severe symptomatic XXXX .

@entity1 @entity932 @entity64 @entity63 @entity4905 @entity1188 @entity731 @entity850 @entity204 @entity4522
BACKGROUND AND PURPOSE: Intracranial @entity731 is especially prevalent in Asians, but intracranial stent placement and medical treatment for severe @entity932 are controversial. Thus, we compared long-term outcomes of these 2 therapeutic approaches in an Asian population. MATERIALS AND METHODS: @entity1 with angiographically proved severe (>= 70%) symptomatic @entity4522 , with or without stent placement, were retrospectively reviewed at a single center between 2002 and 2009, with adjustments for age, sex, vascular risk factors, degree of baseline @entity850 , and baseline functional status. RESULTS: Of the 114 @entity1 followed from 3 to 36 months (mean, 17.3 months) after initial diagnosis, 53 received 56 stents in addition to medical treatment (stent-placement group), and 61 matched @entity1 received only medical treatment (medical group). Total clinical events, including @entity64 , @entity4905 , and @entity204 , were 12 (22.6%) and 15 (24.6%) in the stent-placement and medical groups, respectively (P = .99). The stent-placement group had significantly better functional outcomes than the medical group (94.3% versus 78.7% for mRS scores of 0-3, P = .045). Most events in the stent-placement group occurred within the first week of the periprocedural period (17.0%) as minor embolic or perforator @entity1188 , and the rate of events decreased thereafter (5.7%, P = .07). Stent placement over the perforator-rich MCA and BA independently predicted periprocedural events on multivariate regression analysis. In the medical group, events increased in frequency (21.7%) and severity with time. CONCLUSIONS: Although the total @entity63 event rate was similar in the 2 groups during a 3-year follow-up, the stent-placement group had a more favorable functional outcome despite minor periprocedural @entity64 .
