Background and Aims The risk of ischemic stroke from a symptomatic stenotic intracranial artery is high despite best medical therapy (BMT). Clinicians have increasingly turned to percutaneous transluminal angioplasty and stenting (PTAS) over the last decades as an alternative therapy in high-risk patient with symptomatic ICAS. We evaluated long-term clinical outcome and restenosis rate with atherosclerotic intracranial stenosis using the Wingspan self-expanding nitinol stent system.
Methods The patients treated with the Wingspan in two medical center from January 2010 to December 2016 were enrolled. Target patients were affected by high-grade, symptomatic, intracranial atherosclerotic lesions, were on antithrombotic therapy and at high stroke risk. Follow up DSA was performed at 1-year. After that, image follow up was done by CTA, MRA or DSA. The patients were followed up at least 3 years.
Results 43 patients treated with Wingspan stent for symptomatic intracranial stenosis were enrolled in this study. The frequency for any stroke or death within 30-days was 7%. The frequency of any stroke or death after 30-day was also 7% at mean 58.7 months follow up period. The frequency of >50% restenosis on 3-year follow up image was 18%(n=8/43). There was complete occlusion in 9%(n=4/43). Reballooning was done in the other 4 patients but final occlusion was seen in 2 patients.
Conclusions The use of Wingspan stent in patient with >50% symptomatic intracranial stenosis is associated with good long term clinical outcome. Long term restenosis rate was not high and asymptomatic in most patients. The incidence of symptomatic infarct was low among the restenosis patients.
Disclosures S. Park: None. S. Seo: None. J. Kim: None.
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