title: Treatment of high risk symptomatic intracranial atherosclerosis with balloon mounted coronary stents and Wingspan stents: single center experience over a 10 year period.
abstract: BACKGROUND
  Stenting of symptomatic intracranial atherosclerosis remains under investigation, yet this option to potentially avert subsequent stroke has been offered at select centers under humanitarian device exemption and off-label use for several years.
  
  
  METHODS
  Retrospective case series of consecutive patients undergoing stenting with Wingspan and balloon mounted coronary stents for symptomatic intracranial atherosclerosis at a single institution. Recurrent symptomatic ischemia in the territory of the stented artery was ascertained. Rates of recurrent ischemic stroke were calculated per patient-year of follow-up and were compared with medically treated patients in the Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) trial.
  
  
  RESULTS
  During the 10 year study period, 41 cases of intracranial stenting were identified. Stenoses were severe (>70%) in 88% of patients. Stenting procedures occurred a median of 14 days from the most recent symptomatic event. 19 Wingspan stents and 22 balloon mounted coronary stents were deployed. Four strokes occurred within 24 h of stenting, seven within 1 month and eight within 3 months. By 3 months after stenting, no further strokes occurred during up to 2 years of follow-up. Patients had 0.194 ischemic strokes per person-year of follow-up, compared with 0.083 ischemic strokes per person-year of follow-up in the aspirin arm of WASID and 0.065 ischemic strokes per person-year of follow-up in the warfarin arm of WASID.
  
  
  CONCLUSIONS
  Stenting of symptomatic intracranial atherosclerosis in a high risk subset of cases with advanced degree of luminal stenosis may be associated with an increased early risk of recurrent ischemic stroke.
authors: Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts 02118, USA. tarlov@gmail.com
authors: Nicholas
authors: N
authors: Tarlov
authors: Reza
authors: R
authors: Jahan
authors: Jeffrey L
authors: JL
authors: Saver
authors: James W
authors: JW
authors: Sayre
authors: Latisha K
authors: LK
authors: Ali
authors: Doojin
authors: D
authors: Kim
authors: Gary R
authors: GR
authors: Duckwiler
authors: Satoshi
authors: S
authors: Tateshima
authors: Fernando
authors: F
authors: Viñuela
authors: David S
authors: DS
authors: Liebeskind
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000295:instrumentation* / Q000379:methods; D016893:Carotid Stenosis / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D003331:Coronary Vessels / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic / Q000639:trends; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome