Background and Purpose Recanalization with the Wingspan stent, which can be deployed rapidly and safely, is an option for treating acute middle cerebral artery (MCA) secondary division (M2) occlusion when intravenous thrombolysis has failed or is contraindicated. The purpose of this study was to evaluated feasibility, efficacy, and safety of recanalization for acute MCA M2 occlusion using the Wingspan stent.
Methods We report 10 patients with acute MCA M2 occlusion in whom recanalization was not achieved with a standard intravenous thrombolysis, or who were ineligible for intravenous thrombolysis or who presented after 3 h of symptom onset and the stenting could be completed within 8 h from symptom onset. We analyzed angiographic and clinical results.
Results Successful recanalization with the Wingspan stent were achieved in all patients. The mean NIHSS score on admission was 13.8 points (range 6–23). The occlusion site were located in the superior division (n=4, left:3, right:1), the middle division (n=1, right) and the inferior division (n=5, all: right) of MCA. The mean time interval from stroke symptom onset to stenting was 348.9±90.4 min. No intracranial hemorrhage, vessel perforations or dissections occurred in any patient. One patient developed acute thrombosis in distal ICA of a stented side at 4 days after placement and was managed well with mechanical thrombectomy. All patients improved on the NIHSS (mean amount: 8.8) and to an NIHSS score of 5±4.6 (median 4.5, range 0–15) at 7 days. At discharge, an mRS of ≤3 was achieved in 8 patients (80%) and an mRS of ≤2 was achieved in six patients (60%).
Conclusions This case series demonstrated the feasibility of using a Wingspan stent safely and effectively for acute MCA M2 occlusions when intravenous thrombolysis failed or was contraindicated.
Competing interests None.
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