Document Detail

Impact of operator and site experience on outcomes after angioplasty and stenting in the SAMMPRIS trial.
MedLine Citation:
PMID:  22977278     Owner:  NLM     Status:  Publisher    
BACKGROUND AND PURPOSE: To investigate the relationship between physician and site experience and the risk of 30 day hemorrhagic and ischemic strokes in the stenting arm of the Stenting and Aggressive Medical Management for the Prevention of Recurrent Ischemic Stroke (SAMMPRIS) trial. METHODS: Study records and an investigator survey were examined for physician and site related factors, including: number of Wingspan and aneurysm stents submitted for credentialing, number of study procedures performed in SAMMPRIS, years in practice after training, primary specialty, and site enrollment. Bivariate and multivariate analyses were performed to determine if these factors were associated with the 30 day rate of cerebrovascular events after angioplasty and stenting. RESULTS: 213 patients underwent angioplasty alone (n=5) or angioplasty and stenting (n=208) with study devices by 63 interventionists at 48 sites. For credentialing, the median number of Wingspan and similar aneurysm stent cases submitted by study interventionists were 10 and 6, respectively. Interventionists with higher numbers (>10) of Wingspan cases submitted for credentialing tended to have higher rates of 30 day events (19.0% vs 9.9%) than those with <10 cases. High enrolling sites in the trial tended to have lower rates of hemorrhagic stroke (9.8% at sites enrolling <12 patients vs 2.7% at sites enrolling >12 patients). CONCLUSIONS: Interventionists credentialed with less Wingspan experience were not responsible for the high rate of periprocedural stroke in SAMMPRIS. Hemorrhagic stroke may be related to low enrollment in the trial but not previous Wingspan experience.
Colin P Derdeyn; David Fiorella; Michael J Lynn; Stanley L Barnwell; Osama O Zaidat; Philip M Meyers; Y Pierre Gobin; Jacques Dion; Bethany F Lane; Tanya N Turan; L Scott Janis; Marc I Chimowitz;
Related Documents :
12759638 - Heterotopic ossification after knee dislocation: the predictive value of the injury sev...
18941848 - Postoperative lateral ligamentous laxity diminishes with time after tka in the varus knee.
11600978 - Anterior cruciate ligament reconstruction in patients with or without accompanying inju...
12435658 - Simultaneous bilateral anterior cruciate ligament reconstruction.
23258288 - Reconstruction of pharyngeal defects with a submental island flap after hypopharyngeal ...
20006818 - Relationship of infantile periocular hemangioma depth to growth and regression pattern.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-12
Journal Detail:
Title:  Journal of neurointerventional surgery     Volume:  -     ISSN:  1759-8486     ISO Abbreviation:  J Neurointerv Surg     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101517079     Medline TA:  J Neurointerv Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Mallinckrodt Institute of Radiology and the Departments of Neurology and Neurosurgery, Washington University School of Medicine, St Louis, Missouri, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Risk factors for coronary heart disease and survival after myocardial infarction.
Next Document:  A comparative study of ethylene growth response kinetics in eudicots and monocots reveals a role for...