Safety and Efficacy of Wingspan Stenting for Severe Symptomatic Atherosclerotic Stenosis of the Middle Cerebral Artery: Analysis of 278 Continuous Cases.
OBJECTIVE
Our objective is to investigate the safety and long-term efficacy of the Wingspan stent (Boston Scientific, Natick, MA, USA) for treating severe atherosclerotic stenosis of the middle cerebral artery (MCA).


METHODS
A total of 278 consecutive patients from our stroke database with clinical symptoms within the prior 90 days and intracranial atherosclerotic stenosis of 70% or above of the MCA were enrolled in this study between September 2012 and November 2014, and these patients were followed until the end of June 2015. The endpoint events included any stroke or death within 30 days after stenting and any subsequent ipsilateral ischemic stroke.


RESULTS
Among the 278 enrolled patients, 277 patients (99.6%) successfully underwent stenting. The mean rate of stenosis decreased from 82.5 ± 7.9% to 9.0 ± 3.2% following treatment. Within 30 days after stenting, 12 patients (4.3%) experienced endpoint events, including 8 cases (2.9%) of hemorrhagic stroke and 4 cases (1.4%) of ischemic stroke; 2 perioperative deaths occurred. During 8-33 months of follow-up, 19 patients developed endpoint events. The 1- and 2-year endpoint event rates were 5.8% (95% confidence interval [CI], 5.0%-15.7%) and 7.2% (95% CI, 4.3%-10.1%), respectively.


CONCLUSIONS
From this study, we can conclude that the treatment of severe symptomatic atherosclerotic stenosis of the MCA using the Wingspan stent was safe and effective and that the long-term stroke recurrence rate after stenting was low.
Department of Neurology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Ting
T
Zhao
Department of Neurology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Wen-Yao
WY
Zhu
Department of Neurology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Xiao-Yi
XY
Xiong
Department of Neurology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Jie
J
Li
Department of Neurology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Li
L
Wang
Department of Neurology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Hui-Yan
HY
Ding
Department of Neurology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Fei
F
Wei
Department of Neurology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Yu
Y
Zhou
Department of Neurology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Zi-Li
ZL
Gong
Department of Neurology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Sai-Yu
SY
Cheng
Department of Neurology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Yong
Y
Liu
Department of Neurology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Jie
J
Shuai
Department of Neurology, Xinqiao Hospital, Third Military Medical University, Chongqing, China. Electronic address: yangqwmlys@hotmail.com.
Qing-Wu
QW
Yang
D000368:Aged; D015901:Angiography, Digital Subtraction; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D002545:Brain Ischemia / Q000209:etiology; D002533:Cerebral Angiography / Q000379:methods; D003251:Constriction, Pathologic; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D020300:Intracranial Hemorrhages / Q000209:etiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D011474:Prosthesis Design; D012008:Recurrence; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index; D015607:Stents; D020521:Stroke / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome
Middle cerebral artery stenosis; Wingspan stent; efficacy; medical treatment