The WingSpan Stent System for the Treatment of Intracranial Atherosclerotic Stenoses: A Single Center Experience.

Lee,  Deok Hee; Morsi,  Hesham; Diaz Daza,  Orlando; Arat,  Anil; Mawad,  Michel E

Original Article

Neurointervention 2009;4(2):87-93.

The WingSpan Stent System for the Treatment of Intracranial Atherosclerotic Stenoses: A Single Center Experience.

Deok Hee Lee, Hesham Morsi, Orlando Diaz Daza, Anil Arat, Michel E Mawad

¹St. Luke's Episcopal Hospital Texas Heart Institute, Baylor College of Medicine, Houston, Texas, USA. dhlee@amc.seoul.kr
²Department of Radiology Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Korea.

Abstract

PURPOSE
A self-expandable nitinol stent (WingSpan stent; Boston Scientific Corp.) was introduced for the treatment of intracranial stenoses. The purpose of this study is to present our initial experience with the WingSpan stent for the treatment of atherosclerotic stenoses of the cerebral arteries.
MATERIALS AND METHODS
Consecutive 37 patients (mean age: 66.8 years, 17 men and 20 women) with symptomatic severe stenoses (>50%) of various anatomic sites were treated with WingSpan stent (BSC). Treatment result was evaluated in terms of technical success rate, intra-procedural event, and clinical course. Neurological morbidity and mortality rates were obtained. Arterial patency was evaluated with the 6 month follow-up angiography. Restenosis over 50% was regarded as significant.
RESULTS
The technical success rate was 97.3% (36/37). Flow-limiting vasospasm or dissection after balloon angioplasty (n=3), misplacement of the stent (n=3), and acute in-stent thrombosis (n=1) were occurred. The initial stenosis before the procedure (71.7%) was improved after balloon angioplasty (39.8%) and after subsequent stent placement (20.0%). There were four neurological events during periprocedural period. Those were two TIA, one minor stroke, and one major stroke. The periprocedural morbidity rate was 5.4%. One mortality was the case of progression of previous brainstem infarction. Six-month-follow-up angiography was available in 16 patients and in-stent restenosis was noted in 7 (43.8%).
CONCLUSION
WingSpan stents could be delivered to the target lesions without difficulty. However, the system showed technical problems such as misplacement. Restenosis seemed not infrequent on our limited follow-up observations.

Key Words: Arterial stenosis; Stroke; Stent; Angioplasty