Purpose The purpose of this study is to investigate the treatment results, and procedure-related complications of stent-angioplasty for symptomatic intracranial arterial stenosis with Wingspan stent and Gateway balloon.

Materials and methods From May. 2010 to May 2015, 76 patients (52 males, 24 females, mean age: 66.6 ± 8.9 years) with symptomatic intracranial arterial stenosis were treated. Inclusion criteria are acute and/or subacute symptomatic infarction or repeated transient ischemic attack (TIA) (infarction vs. TIA: 39 vs. 37) and severe stenosis related to symptoms confirmed with catheter angiography. The numbers of stenotic lesions were 29 cases on ICA, 34 on MCA, and 13 on vertebrobasilar (V-B) artery. All of the used stents for treatment were Wingspan self-expanding stent and Gateway balloon. Mean NIHSS at admission was 1.4 ± 1.9, and mean stenosis rate was 76.8 ± 6.2%. Clinical status (including NIHSS) and angiographic results were assessed retrospectively.

Results Stents were successfully deployed at first trial in almost all cases except only two cases due to tortuous ICA course (97.4%), and in one case successful stenting was done at second trial (98.7%). Periprocedural complications occurred in 11 cases (14.5%), and symptomatic cases were only 6 (7.9%, transient vs. permanent: 4 (5.3% vs. 2.6%). Of 76 cases 67 were followed clinically over 6 months (88.2%) and the mean follow-up period was 25.8 ± 20.0 months). Angiographic follow-up was performed in 57 cases (75.0%. 13.9 ± 11.8 months). The mean NIHSS after stent-angioplasty was 0.8 ± 1.7 and 0.5 ± 1.7 at last clinical follow-up day. Post-stenting residual stenosis was 8.7 ± 13.0%, and 14.8 ± 25.3% at last angiographic follow up. In-stent restenosis over 50% occurred in 7 cases (7/57, 12.3%), and 6 cases were retreated successfully with Gateway balloon (3) or Drug-eluting balloon (3). Symptomatic infarctions were occurred in 4 of 76 (5.3%) patients during the clinical follow-up period.

Conclusion Stent-angioplasty with Wingspan self-expanding stent appeared to be safe and effective for intracranial arterial stenotic disease. However, it should prompt more strict selection criteria and desperate angiographic follow-up for better clinical results.

Disclosures S. You: None.