US multicenter experience with the wingspan stent system for the treatment of intracranial atheromatous disease: periprocedural results.
OBJECTIVE
The current report details our initial periprocedural experience with Wingspan (Boston Scientific/Target), the first self-expanding stent system designed for the treatment of intracranial atheromatous disease.


METHODS
All patients undergoing angioplasty and stenting with the Gateway balloon-Wingspan stent system were prospectively tracked.


RESULTS
During a 9-month period, treatment with the stent system was attempted in 78 patients (average age, 63.6 years; 33 women) with 82 intracranial atheromatous lesions, of which 54 were > or =70% stenotic. Eighty-one of 82 lesions were successfully stented (98.8%) during the first treatment session. In 1 case, the stent could not be delivered across the lesion; the patient was treated solely with angioplasty and stented at a later date. Lesions treated involved the internal carotid (n=32; 8 petrous, 10 cavernous, 11 supraclinoid segment, 3 terminus), vertebral (n=14; V4 segment), basilar (n=14), and middle cerebral (n=22) arteries. Mean+/-SD pretreatment stenosis was 74.6+/-13.9%, improving to 43.5+/-18.1% after balloon angioplasty and to 27.2+/-16.7% after stent placement. Of the 82 lesions treated, there were 5 (6.1%) major periprocedural neurological complications, 4 of which ultimately led to patient death within 30 days of the procedure.


CONCLUSIONS
Angioplasty and stenting for symptomatic intracranial atheromatous disease can be performed with the Gateway balloon-Wingspan stent system with a high rate of technical success and acceptable periprocedural morbidity. Our initial experience indicates that this procedure represents a viable treatment option for this patient population.
Fiorella
David
D
Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. fioreld@ccf.org
Levy
Elad I
EI
Turk
Aquilla S
AS
Albuquerque
Felipe C
FC
Niemann
David B
DB
Aagaard-Kienitz
Beverly
B
Hanel
Ricardo A
RA
Woo
Henry
H
Rasmussen
Peter A
PA
Hopkins
L Nelson
LN
Masaryk
Thomas J
TJ
McDougall
Cameron G
CG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000295:instrumentation* / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000379:methods; D004867:Equipment Design; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging / Q000601:surgery*; D007431:Intraoperative Complications / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000295:instrumentation / Q000379:methods; D011446:Prospective Studies; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome; D014481:United States