Evidence map›Paper›PMID 39455066›Full record

SynthesisStroke and vascular neurology2025

Stenting for symptomatic intracranial arterial stenosis with different qualifying arteries: a preplanned pooled individual patient data analysis.

Tianhua Li, Jichang Luo, Xuesong Bai, Eyad Almallouhi, Peng Gao, Delin Liu, Ran Xu, Wenlong Xu, Guangdong Lu, Haozhi Gong and 10 more

Abstract readComparative StudyMeta-AnalysisComparative Study
In one paragraph

Synthesis in Stroke and vascular neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Tianhua Li *Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China.ORCID http://orcid.org/0000-0002-3099-905X
Jichang Luo *Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China.
Xuesong Bai *Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China.
Eyad AlmallouhiNeuro Interventional Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.ORCID http://orcid.org/0000-0002-6873-7901
Peng GaoDepartment of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China.
Delin LiuDepartment of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China.
Ran XuDepartment of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China.
Wenlong XuDepartment of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China.
Guangdong LuDepartment of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China.
Haozhi GongDepartment of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China.ORCID http://orcid.org/0000-0003-1910-227X
Xiao ZhangDepartment of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China.
Taoyuan LuDepartment of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China.
Jie WangDepartment of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China.
Renjie YangDepartment of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China.
Zixuan XingHealth Science Center, Xian Jiaotong University, Xi'an, Shaanxi, China.
Guangjie LiuDepartment of Neurosurgery, Southern Medical University, Guangzhou, Guangdong, China.
Yufu DaiDepartment of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China.
Colin P DerdeynDepartment of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA.
Liqun JiaoDepartment of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China liqunjiao@sina.cn wangtao_dr@sina.com.ORCID http://orcid.org/0000-0003-4982-6295
Tao WangDepartment of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China liqunjiao@sina.cn wangtao_dr@sina.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe efficacy of percutaneous transluminal angioplasty and stenting (PTAS) relative to medical management in treating symptomatic intracranial arterial stenosis (ICAS) varies based on the qualifying artery. This study aims to evaluate PTAS compared with medical therapy alone in cases of ICAS involving the internal carotid artery (ICA), middle cerebral artery (MCA), vertebral artery (VA) and basilar artery (BA).

methodsThis study involves a thorough pooled analysis of individual patient data from two randomised controlled trials, evaluating the efficacy of PTAS in comparison to medical management for symptomatic ICAS with different qualifying arteries. The primary outcome was stroke or death within 30 days postenrolment, or stroke in the region of the qualifying artery beyond 30 days through 1 year. A methodology based on intention-to-treat was employed, and HR accompanied by 95% CIs were used to convey risk estimates.

resultsThe data of 809 individuals were collected from Stenting vs Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis trial and China Angioplasty and Stenting for Symptomatic Intracranial Severe Stenosis trial. Four hundred were designated for PTAS, while 409 were assigned to medical therapy alone. For the primary outcome, patients with symptomatic BA stenosis had a significantly higher risk of receiving PTAS compared with medical therapy (17.17% vs 7.77%; 9.40; HR, 2.38 (1.03 to 5.52); p=0.04). However, PTAS had no significant difference in patients with symptomatic ICA (26.67% vs 16.67%; HR, 1.68 (0.78 to 3.62); p=0.19), MCA (8.28% vs 9.79%; HR, 0.85 (0.42 to 1.74); p=0.66) and VA stenosis (9.52% vs 10.71%; HR, 0.91 (0.32 to 2.62); p=0.86) compared with medical therapy.

conclusionsPTAS significantly increases the risk of both short-term and long-term stroke in patients with symptomatic BA stenosis. Without significant technological advancements to mitigate these risks, PTAS offers limited benefits. For symptomatic ICA, MCA and VA stenosis, PTAS provided no significant advantage.

Indexed as

Angioplasty, Balloon, CoronaryCarotid StenosisConservative TreatmentIntracranial Arterial DiseasesStrokeAgedArteriesFemaleHumansIntention to Treat AnalysisMaleMiddle AgedProportional Hazards ModelsRandomized Controlled Trials as TopicRisk AssessmentRisk FactorsIschemic Stroke

Identifiers

PMID39455066
PMCPMC12415638

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.