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. 2014 Mar;6(2):96-102.
doi: 10.1136/neurintsurg-2012-010608. Epub 2013 Mar 19.

Angioplasty and stenting of intracranial atherosclerosis with the Wingspan system: 1-year clinical and radiological outcome in a single Asian center

Simon Chun Ho Yu  1 , Thomas Wai Hong Leung, Kwok Tung Lee, Lawrence Ka Sing Wong
Affiliations
Free PMC article

Angioplasty and stenting of intracranial atherosclerosis with the Wingspan system: 1-year clinical and radiological outcome in a single Asian center

Simon Chun Ho Yu et al. J Neurointerv Surg. 2014 Mar.
Free PMC article

Abstract

Background: This study aimed to evaluate the 1-year clinical and angiographic outcome of angioplasty and stenting of intracranial atherosclerosis using Wingspan and Gateway system.

Methods: In this prospective study, patients with symptomatic lesions were treated and followed clinically and angiographically by digital subtraction angiography (DSA) for 1 year. The two primary endpoints were recurrent ipsilateral ischemic stroke and in-stent restenosis (ISR) at 1 year. Secondary endpoints included periprocedural death or stroke and all strokes at 1 year. Potential factors correlated with ISR were studied using univariate and multivariate analysis.

Results: Treatment was attempted in 65 patients and successfully completed in 61 (93.8%). Fifty-nine patients (44 men, 15 women) aged 62.86 ± 11.38 years with 66 stenoses (average degree of stenosis 71.78 ± 11.23%) underwent clinical and DSA follow-up at 1 year. There were 66 stenotic lesions. ISR occurred in 11 of the 66 lesions (16.7%). Luminal gain occurred in 32 of the lesions (48.5%), an unchanged lumen in 4 (6%) and luminal loss in 30 (45.4%). The periprocedural stroke or death rate was 6.1% (4/65), including three hemorrhagic and one ischemic stroke, all of which occurred at the corresponding site and resulted in death. There were no interval strokes between the periprocedural time and the 1-year follow-up. The occurrence of ISR was correlated with the degree of stenosis before treatment and was not correlated with patient age or sex, vessel diameter, location of stenosis or failure to control risk factors for atherosclerosis.

Conclusions: One-year clinical and angiographic outcomes of angioplasty and stenting are promising for symptomatic intracranial atherosclerosis.

Keywords: Angioplasty; Atherosclerosis; Intervention; Stenosis; Stent.

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Figures

Figure 1
Figure 1
Degree of stenosis at prestenting baseline (indicated by the right end of the white bar) and degree of residual stenosis immediately after stenting (indicated by the right end of the grey bar).
Figure 2
Figure 2
In a man with stenosis at the carotid siphon, digital subtraction angiography showed 62.5% stenosis at prestenting baseline (A), a residual stenosis of 53.3% immediately post-stenting (B), and 18.2% stenosis at 1 year (C). There was a 75% luminal gain 1 year after stenting (C). The lesion is shown by an arrow and the ends of the stent are indicated by arrowheads.
Figure 3
Figure 3
In a man with stenosis at distal V3, digital subtraction angiography showed 66.7% stenosis at prestenting baseline (A), a residual stenosis of 43.6% immediately post-stenting (B), and 86.6% stenosis at 1 year (C). There was a 72.7% luminal loss 1 year after stenting (C). The lesion is shown by an arrow and the ends of the stent are indicated by arrowheads.
See this image and copyright information in PMC

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