Stenting for symptomatic intracranial arterial stenosis with Wingspan stents:complications analysis at a single center

Abstract

Objective To assess the safety of stenting for symptomatic intracranial atherosclerosis with Wingspan stents and debate the factors related to complications. Methods 433 consecutive patients with intracranial atherosclerosis were treated with Wingspan stents from July 2007 to April 2013 in our center,all of the patients included suffered from ischemic stroke or transient ischemic attack attributed to the atherosclerosis stenosis with narrowing of at least 70%.the initial 100 cases completed by the operators were taken into the unskilled stage and the rest 333 cases were taken into the skilled stage.A Chi-squared or Fisher's exact test was used to analyse the factors possible related to the complications. Results Stenting procedures were successfully performed in 429 of 433 cases(99. 1%), The mean stenosis was reduced from(82. 3±7. 6)% to(16. 6±6. 6)%; strokes or death happened in 29 cases within 30 days, among these, 7 patients suffered from disabling or fatal strokes; 21(4. 8%)cases had ischemic strokes within 30 days and 8(1. 8%)cases had hemorrhagic strokes within 30 days; the rates of strokes, ischemic strokes、perforator strokes in basilar artery stentings within 30 days were apparently higher than those in other artery stentings; the rate of hemorrhagic strokes within 30 days in middle cerebral artery stentings was higher than in other arteries stentings; The rate of strokes within 30 days at the unskilled stage was apparently higher than at the skilled stage(13. 0% vs.4. 8%, P 0. 05). Conclusion Stenting with Wingspan for intracranial atherosclerosis stenosis was feasible and safe and associated with a low periprocedural complication rate; the ischemic strokes rate within 30 days in basilar artery stentings was higher than in other arteries stentings; the rate of hemorrhagic strokes within 30 days in middle cerebral artery was higher than in other arteries stentings; the complications related to the operation were influenced by the operators'experience frequently; but the rate of perforator strokes could not be reduced by the technically skilled operators. Key words: Atherosclerosis; Stent; Stenosis; Intracranial arteries disease