title: MRI audit of complications in intracranial stenosis treated with Wingspan device.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of the Wingspan device for the treatment of symptomatic intracranial atherosclerotic stenosis (ICAS).
  
  
  METHODS
  We audited a prospective ongoing database of consecutive patients who received Wingspan stenting between January 2013 and December 2015. All patients underwent MRI to audit any complications during the early follow-up period. We focused on the clinical demographics, lesion characteristics, treatment results, and periprocedural complications. Functional outcomes were measured with the modified Rankin Scale (mRS) at discharge and after 3 months.
  
  
  RESULTS
  Intracranial stenting was performed in 50 patients (100%). Mean stenosis pre-stenting was 76.5±13.1% and post-stenting residual stenosis was 19.8±13.8%. The overall 30-day rate of procedure-related complications was 6.0% (3/50). Two patients (4%) developed in-stent restenosis, one of whom had a dissection at the middle cerebral artery. Interestingly, on the follow-up MRI scan there was a high incidence of asymptomatic diffusion-weighted imaging (DWI) hyperintensities, 46% (23/50) presumed to be due to microembolic causes. At the 90-day, 180-day, and 1-year follow-up, three patients had further strokes resulting in a total complication rate of 12%. 92% had excellent outcomes (mRS 0-1) and only one patient had deterioration of his mRS score.
  
  
  CONCLUSIONS
  ICAS treated by Wingspan stenting using pre-placement balloon angioplasty appears safe and effective with a high technical success rate and favorable outcomes. There is a high incidence of asymptomatic DWI hyperintensites post-procedure, but these do not appear to result in long-term sequelae.
authors.affiliation: Division of Neurology, Department of Medicine, National University Health System, Singapore, Singapore.
authors.forename: Leonard L L
authors.initials: LL
authors.lastname: Yeo
authors.affiliation: Division of Neuroradiology, Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Linkou, Taiwan.|College of Medicine and School of Medical Technology, Chang Gung University; Taoyuan, Taiwan.
authors.forename: Y M
authors.initials: YM
authors.lastname: Wu
authors.affiliation: College of Medicine and School of Medical Technology, Chang Gung University; Taoyuan, Taiwan.|Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Keelung, Taiwan.
authors.forename: Y L
authors.initials: YL
authors.lastname: Chen
authors.affiliation: Division of Neuroradiology, Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Linkou, Taiwan.|College of Medicine and School of Medical Technology, Chang Gung University; Taoyuan, Taiwan.
authors.forename: C H
authors.initials: CH
authors.lastname: Yeh
authors.affiliation: College of Medicine and School of Medical Technology, Chang Gung University; Taoyuan, Taiwan.|Department of Neurology, Stroke Center, Linkou Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: T H
authors.initials: TH
authors.lastname: Lee
authors.affiliation: Division of Neuroradiology, Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Linkou, Taiwan.|College of Medicine and School of Medical Technology, Chang Gung University; Taoyuan, Taiwan.
authors.forename: H F
authors.initials: HF
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon / Q000295:instrumentation / Q000379:methods*; D054869:Clinical Audit / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome
keywords: Complication; Embolic; MRI; Stent; Stroke