Rate of postprocedural stroke and death in SAMMPRIS trial-eligible patients treated with intracranial angioplasty and/or stent placement in practice

Farhan Siddiq, Saqib A. Chaudhry, Rakesh Khatri, Gustavo J. Rodriguez, Ramachandra Tummala, M. Fareed K. Suri, Adnan I. Qureshi

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

BACKGROUND: The SAMMPRIS (Stenting vs Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis) trial, comparing aggressive medical vs stent treatment in patients with symptomatic intracranial stenosis, was halted after a 14% stroke and death rate was observed in the stent-treated group. OBJECTIVE: To study the 30-day stroke and death rate in intracranial angioplasty- and stent-treated patients meeting SAMMPRIS trial eligibility criteria. METHODS: A retrospective analysis of 96 patients treated with intracranial angioplasty and stent placement at 3 university-affiliated institutions was performed. Patients were divided into SAMMPRIS trial eligible and ineligible groups based on inclusion and exclusion criteria for the SAMMPRIS trial. RESULTS: Sixty-nine patients were determined to be SAMMPRIS eligible and 27 patients were ineligible. The SAMMPRIS-eligible group was divided into angioplastyand stent-treated subgroups (30 and 39 patients, respectively). The overall 30-day postprocedure stroke and death rate was 7.2% in the SAMMPRIS-eligible group and 7.4% in the SAMMPRIS-ineligible group (P = .97). The 30-day postprocedure stroke and death rate was 3.3% in the SAMMPRIS-eligible, angioplasty-treated subgroup and 10.2% in the SAMMPRIS-eligible, stent-treated subgroup (P = .27). CONCLUSION: The overall 30-day postprocedure stroke and death rate in our study was lower in both SAMMPRIS-eligible and -ineligible groups than the reported 14% stroke and death rate in the SAMMPRIS trial. We hypothesize that a more judicious use of primary angioplasty may be responsible for better postprocedure outcomes and should be considered an acceptable treatment in future trials.

Original languageEnglish (US)
Pages (from-to)68-73
Number of pages6
JournalNeurosurgery
Volume71
Issue number1
DOIs
StatePublished - Jul 2012

Keywords

  • Intracranial angioplasty
  • Intracranial stent
  • Randomized clinical trial
  • SAMMPRIS trial
  • Stroke

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