Wingspan Stenting for Severe Symptomatic Intracranial Atherosclerotic Stenosis in 433 Patients Treated at a Single Medical Center

Abstract

PURPOSE: To investigate the safety and outcome of intracranial stenting for intracranial atherosclerotic stenosis (IAS). MATERIALS AND METHODS: Between July 2007 and April 2013, 433 consecutive patients with IAS > 70% underwent intracranial Wingspan stenting, and the data were prospectively analyzed. RESULTS: Intracranial stenting was successful in 429 patients (99.1%), and the mean stenosis rate was improved from prestenting (82.3 ± 7.6)% to poststenting (16.6 ± 6.6)%. During the 30-day perioperative period, 29 patients (6.7%) developed stroke. The total perioperative stroke rate was significantly (P < 0.01) higher in the basilar artery area than in others, whereas the hemorrhagic stroke rate was significantly (P < 0.05) greater in the middle cerebral artery area than in others. The experience accumulation stage (13%) had a significantly (P < 0.05) higher stroke rate than the technical maturation stage (4.8%). Clinical follow-up 6-69 months poststenting revealed ipsilateral stroke in 20 patients (5.5%). The one- and two-year cumulative stroke rates were 9.5% and 11.5%, respectively; the two-year cumulative stroke rate was significantly (P < 0.05) greater in the experience accumulation stage (18.8%) than in the technical maturation stage (9.1%). CONCLUSION: Wingspan stenting for intracranial atherosclerotic stenosis is safe and the long-term stroke rate after stenting is low in a Chinese subpopulation.