title: Outcome of patients with ≥70% symptomatic intracranial stenosis after Wingspan stenting.
abstract: OBJECTIVE
  There were limited data on the long-term outcome of patients with symptomatic intracranial atherosclerotic stenosis ≥70% after Wingspan stenting. Using our Wingspan cohort data and the data from the Warfarin and Aspirin for Symptomatic Intracranial Atherosclerotic Disease (WASID) as a historical control, we tested the hypothesis that stenting provided no benefit over antithrombotic therapy alone for these high-risk patients.
  
  
  METHODS
  Between January 2007 and February 2009, 100 consecutive patients with intracranial atherosclerotic stenosis ≥70% and symptoms within 90 days were enrolled into this prospective single-center Wingspan cohort study and followed up until the end of February 2010. Stenosis was measured per the WASID criteria. One-year risk of primary end point (any stroke or death within 30 days and ipsilateral ischemic stroke afterward) was compared with that of ipsilateral ischemic stroke in the WASID patients with ≥70% stenosis.
  
  
  RESULTS
  The stent placement success rate was 99%. All patients but 1 had clinical follow-up of ≥12 months. During a mean follow-up of 1.8 years, 9 patients developed primary end point events (5 within 30 days and 4 afterward). The 1-year risk of the outcome events was lower than that in similar WASID patients: 7.3% (95% CI, 2.0% to 12.5%) versus 18% (95% CI, 13% to 24%; P<0.05).
  
  
  CONCLUSIONS
  The clinical outcome of Wingspan stenting for high-risk intracranial atherosclerotic stenosis patients in this high-volume center study compares favorably with that of antithrombotic therapy alone. A randomized trial comparing medical therapy alone with medical therapy plus Wingspan stenting, conducted at high-volume centers, is needed to confirm the stenting benefit.
authors.affiliation: Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Beijing, China 100050. cjr.jiangweijian@vip.163.com
authors.forename: Wei-Jian
authors.initials: WJ
authors.lastname: Jiang
authors.forename: Wengui
authors.initials: W
authors.lastname: Yu
authors.forename: Bin
authors.initials: B
authors.lastname: Du
authors.forename: Feng
authors.initials: F
authors.lastname: Gao
authors.forename: Li-Ying
authors.initials: LY
authors.lastname: Cui
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects*; D000925:Anticoagulants / Q000494:pharmacology; D015331:Cohort Studies; D003251:Constriction, Pathologic / Q000209:etiology*; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000209:etiology*; D002546:Ischemic Attack, Transient / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D015607:Stents / Q000009:adverse effects; D020521:Stroke / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants