title: Intracranial atheromatous disease treatment with the Wingspan stent system: evaluation of clinical, procedural outcome and restenosis rate in a single-center series of 21 consecutive patients with acute and mid-term results.
abstract: BACKGROUND
  Intracranial atherosclerosis may be the underlying pathology in up to 15% of ischemic strokes, but may account for about 40% of strokes in some populations. After an ischemic event determined by intracranial atherosclerosis, patients have a 12% annual risk of stroke recurrence, mostly during the first year.
  
  
  OBJECTIVE
  To evaluate procedural safety, clinical outcome and restenosis rate of Wingspan stent placement.
  
  
  METHODS
  Twenty-one caucasoid patients were enrolled. Target patients were affected by high-grade, symptomatic, intracranial atherosclerotic lesions, were on antithrombotic therapy and at high stroke risk. All patients were treated with the Wingspan stent system.
  
  
  RESULTS
  Technical success resulted 100%, with all target lesions being reduced to <50%. No stroke or death were observed at 30. The mean percent of stenosis was reduced from a middle value of 84% to a middle value of 17% after stent placement. Medium follow-up was 19.5months (range 6-36months). No stroke or death occurred in any patient. None of the patients presented a <50% stent patency rate at follow-up.
  
  
  CONCLUSIONS
  The short-term results and follow up analysis provide evidence demonstrating the safety of the Wingspan system when used in high-risk patient population. Due to concerns regarding long-term stent patency and ischemic events occurrence emerged from clinical trials such as the SAMMPRIS, intracranial angioplasty and stent with the Wingspan system should be considered only for high risk patients in which it may be considered the only viable therapeutic option.
authors.affiliation: Fondazione I.R.C.C.S. Policlinico Tor Vergata-- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gandini
authors.forename: Antonio
authors.initials: A
authors.lastname: Chiaravalloti
authors.forename: Enrico
authors.initials: E
authors.lastname: Pampana
authors.forename: Francesco
authors.initials: F
authors.lastname: Massari
authors.forename: Daniele
authors.initials: D
authors.lastname: Morosetti
authors.forename: Sergio
authors.initials: S
authors.lastname: Spano
authors.forename: Giorgio
authors.initials: G
authors.lastname: Loreni
authors.forename: Giovanni
authors.initials: G
authors.lastname: Simonetti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D017130:Angioplasty; D002545:Brain Ischemia / Q000150:complications / Q000601:surgery; D002533:Cerebral Angiography; D003251:Constriction, Pathologic / Q000517:prevention & control; D023381:Endpoint Determination; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000453:epidemiology*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000209:etiology / Q000601:surgery*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012008:Recurrence; D015607:Stents / Q000009:adverse effects; D020521:Stroke / Q000453:epidemiology / Q000517:prevention & control*; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000497:Alloys; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; C013616:nitinol