Wingspan stenting for intracranial atherosclerotic stenosis: Clinical outcomes and risk factors for in-stent restenosis

Yong Sam Shin, Byung Moon Kim, Sang Hyun Suh, Pyoung Jeon, Dong Joon Kim, Dong Ik Kim, Bum Soo Kim, Keon Ha Kim, Ji Hoe Heo, Hyo Suk Nam, Young Dae Kim

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Abstract

BACKGROUND: Intracranial atherosclerotic stenosis (ICAS) is responsible for 9% to 37% of ischemic strokes. OBJECTIVE: To evaluate the clinical outcome and risk factors for in-stent restenosis (ISR) after treatment of ICAS with a Wingspan stent. METHODS: Seventy-seven patients with 79 total target ICAS > 60% (mean, 79.9 ± 8.4%; symptomatic ICAS, 96.2%) underwent attempted treatment with Wingspan stenting between March 2010 and March 2011. A retrospective review of the prospectively registered data was conducted to assess the risk factors for ISR and the clinical outcomes of these patients. RESULTS: The 30-day transient ischemic attack/stroke and death rates were 5.3% (95% confidence interval [CI], 0.1-10.5) and 0%, respectively. All patients but 1 were followed up clinically for a mean of 18.9 months (range, 12-23 months). During the period, cumulative transient ischemic attack/stroke and death rates were 8.1% (95% CI, 1.7-14.5) and 0%, respectively. Only 1 patient suffered a disabling stroke (subarachnoid hemorrhage), which was associated with retreatment of an ISR with a drug-eluting balloon-expandable stent. Follow-up angiography was available in 69 treated vessels (89.6%) at 3 to 24 months (median, 12 months). Binary ISR rate was 24.6%, of which 17.6% (3 of 17 cases) was symptomatic. Rapid balloon inflation (95% CI, 5.490-530.817) and longer length of stenosis (95% CI, 1.093-1.891) were independent risk factors for ISR. CONCLUSION: Wingspan stenting may be effective for appropriately selected ICAS patients. Rapid balloon inflation and longer lengths of stenosis were independent risk factors for ISR.

Original languageEnglish
Pages (from-to)596-604
Number of pages9
JournalNeurosurgery
Volume72
Issue number4
DOIs
Publication statusPublished - 2013 Apr 1

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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    Shin, Y. S., Kim, B. M., Suh, S. H., Jeon, P., Kim, D. J., Kim, D. I., Kim, B. S., Kim, K. H., Heo, J. H., Nam, H. S., & Kim, Y. D. (2013). Wingspan stenting for intracranial atherosclerotic stenosis: Clinical outcomes and risk factors for in-stent restenosis. Neurosurgery, 72(4), 596-604. https://doi.org/10.1227/NEU.0b013e3182846e09