Abstract
Objective To assess the safety, feasibility and short-mid term effectiveness of the Wingspan stent in the treatment of high-grade symptomatic intracranial atheromatous stenosis. Methods Sixty-three patients with symptomatic intracranial atheromatons stenosis (≥ 70%) were treated with the Gateway balloon-Wingspan stent system. The pre-and post-treatment improvement of symptoms, severity of stenosis, successful rate of treatment, complications were evaluated. Physician-reported follow-up in all 63 patients lasted an average period of 9. 3 months. The X2 test was used for statisties. Results Sixty-three lesions involved the intracranial internal carotid artery (n = 12), middle cerebral artery (n = 22), V4 segment vertebral artery (n = 15), basilar artery (n = 14). Sixty-two lesions were successfully treated with the deployment of the self-expanding Wingspan stent with residual stenosis ≤ 30%. One case failed because of intracranial hemorrhage during the operation. The successful rate of stenting is 98.0% (62/63). The mean stenosis was (82. 3 ± 9. 2) % before treatment, and it improved to (23.0 ± 11.2) % after stent placement. During the follow-up period, 1 patient died of postprocedural hyper-perfusion, one had ischemic stroke after procedure, one presented Homer syndrome at the 11th day, one had iachemic stroke at the 5th month after the procedure, while the other patients had significantly improved. The frequency of ≥50% restenosis on follow-up angiography or computed tomography was 10% (1/10). Conclusions Angioplasty and stenting for high-grade symptomatic intracranial artery stenosis with the Gateway-Wingspan stent system are safe and effective with high rate of technical success, but moderately high rate of residual stenosis and restenosis exist. With the improvement of operation skill and stent system, a better outcome in the future could be achieved. Key words: Vertebasilar insufficiency; Intracranial arteriosclerosis; Angioplasty; Stent
Published Version
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