title: Wingspan stenting can effectively prevent long-term strokes for patients with severe symptomatic atherosclerotic basilar stenosis.
abstract: OBJECTIVE
  To investigate the safety and long-term effect of using the Wingspan stent for severe symptomatic atherosclerotic basilar artery stenosis (≥70%).
  
  
  METHODS
  Between July 2007 and April 2013, we had 91 consecutive patients (age range 41-82 years old) with symptomatic severe basilar stenosis (70-99%) who underwent Wingspan stenting at our center. All patients had stenosis-related temporary ischemic attack or strokes. We analyzed the demographic data, pre- and post-procedural cerebral angiography, technical success rate, peri-procedural complications, and clinical and imaging follow-ups.
  
  
  RESULTS
  The Wingspan stenting procedure was successful in all patients: The stenosis was reduced from 82.2% ± 5.8% pre-stenting to 15.9% ± 5.7% post-stenting. The 30-day peri-operative rate for stroke or death was 14.3%, which included ischemic stroke in 12 cases (12/91 = 13.2%) and subarachnoid hemorrhage in one case (1/91 = 1.1%), with a fatal or disabling stroke rate of 2.2%. Among the 77 patients with clinical follow-up assessment within 7-60 months (mean 31.3 ± 15.1 months) after stenting, four patients (5.2%) had posterior ischemia, including one patient with disabling ischemic stroke (1.3%) and three patients (3.9%) with temporary ischemic attack. The 2-year cumulative stroke rate was 16% (95% CI: 8.2-23.8%). Among 46 patients with imaging assessments at 3-45 months (mean, 9.5 ± 8.3) post-stenting, six (13.0%) patients had restenosis, including two (2/46 = 4.3%) with symptomatic restenosis.
  
  
  CONCLUSIONS
  The benefit of stenting for patients with severe basilar artery stenosis (> 70%) may lie in lowering the long-term fatal and disabling stroke rate; and as long as the peri-operative stroke rate can be kept at a relatively lower level, patients with severe basilar stenosis can benefit from basilar artery stenting.
authors.affiliation: Stroke Center, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China.
authors.forename: Wei-Xing
authors.initials: WX
authors.lastname: Bai
authors.affiliation: Department of Medical Research, Shijiazhuang First Hospital, Hebei Medical University, China.
authors.forename: Bu-Lang
authors.initials: BL
authors.lastname: Gao
authors.affiliation: Stroke Center, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China litianxiaod@163.com.
authors.forename: Tian-Xiao
authors.initials: TX
authors.lastname: Li
authors.affiliation: Stroke Center, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China.
authors.forename: Zi-Liang
authors.initials: ZL
authors.lastname: Wang
authors.affiliation: Stroke Center, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China.
authors.forename: Dong-Yang
authors.initials: DY
authors.lastname: Cai
authors.affiliation: Stroke Center, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China.
authors.forename: Liang-Fu
authors.initials: LF
authors.lastname: Zhu
authors.affiliation: Stroke Center, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China.
authors.forename: Jiang-Yu
authors.initials: JY
authors.lastname: Xue
authors.affiliation: Stroke Center, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China.
authors.forename: Zhao-Shuo
authors.initials: ZS
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015607:Stents; D020521:Stroke / Q000209:etiology* / Q000517:prevention & control*; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000150:complications*
keywords: Adverse effects; Wingspan stent; atherosclerotic stenosis; basilar artery; imaging; intracranial stenting; long-term effect; restenosis; stenosis; stenting procedures; stroke; temporary ischemic attack
references.citation: J Vasc Surg. 2002 Sep;36(3):549-54
references.pmid: 12218980
references.citation: AJNR Am J Neuroradiol. 2008 Nov;29(10):1956-8
references.pmid: 18768730
references.citation: Stroke. 1998 Jul;29(7):1389-92
references.pmid: 9660392
references.citation: Biomed Res Int. 2013;2013:304320
references.pmid: 24350256
references.citation: Stroke. 2009 May;40(5):e340-7
references.pmid: 19182081
references.citation: Neurosurgery. 2007 Sep;61(3):644-50; discussion 650-1
references.pmid: 17881980
references.citation: AJNR Am J Neuroradiol. 2007 May;28(5):808-15
references.pmid: 17494648
references.citation: Stroke. 2011 Jul;42(7):1971-5
references.pmid: 21636814
references.citation: AJNR Am J Neuroradiol. 2008 Jan;29(1):23-7
references.pmid: 17989366
references.citation: Neurosurgery. 2009 Jan;64(1):79-84; discussion 84-5
references.pmid: 19050657
references.citation: Lancet. 1997 Jan 18;349(9046):203-4
references.pmid: 9111559
references.citation: Neurology. 2007 Feb 6;68(6):420-6
references.pmid: 17283316
references.citation: J Am Coll Cardiol. 1989 May;13(6):1425-30
references.pmid: 2522960
references.citation: Neurology. 2000 Aug 22;55(4):490-7
references.pmid: 10953179
references.citation: J Neurointerv Surg. 2010 Jun;2(2):99-103
references.pmid: 21990587
references.citation: N Engl J Med. 2005 Mar 31;352(13):1305-16
references.pmid: 15800226
references.citation: J Neurointerv Surg. 2014 Mar;6(2):96-102
references.pmid: 23512176
references.citation: N Engl J Med. 2011 Sep 15;365(11):993-1003
references.pmid: 21899409
references.citation: Neurology. 2009 Jun 9;72(23):2014-9
references.pmid: 19299309
references.citation: Arch Neurol. 2004 Apr;61(4):496-504
references.pmid: 15096396
references.citation: Lancet. 2014 Jan 25;383(9914):333-41
references.pmid: 24168957
references.citation: J Neurointerv Surg. 2013 Nov;5(6):528-33
references.pmid: 22977278
references.citation: J Neurointerv Surg. 2012 Mar;4(2):85-6
references.pmid: 22318263
references.citation: Stroke. 2012 Oct;43(10):2682-8
references.pmid: 22984008
references.citation: J Clin Neurosci. 2013 Mar;20(3):362-6
references.pmid: 23228656
references.citation: Stroke. 1986 Sep-Oct;17(5):938-42
references.pmid: 3764966
references.citation: Ann Vasc Surg. 2010 May;24(4):474-9
references.pmid: 19892518
references.citation: Neurology. 2006 Oct 10;67(7):1275-8
references.pmid: 17030766
references.citation: AJNR Am J Neuroradiol. 2012 Feb;33(2):343-7
references.pmid: 22173759