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Stroke. 2007;38:881-887
Published online before print February 8, 2007, doi: 10.1161/01.STR.0000257963.65728.e8
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(Stroke. 2007;38:881.)
© 2007 American Heart Association, Inc.

Original Contributions

US Multicenter Experience With the Wingspan Stent System for the Treatment of Intracranial Atheromatous Disease

Periprocedural Results

David Fiorella, MD, PhD; Elad I. Levy, MD; Aquilla S. Turk, MD; Felipe C. Albuquerque, MD; David B. Niemann, MD; Beverly Aagaard-Kienitz, MD; Ricardo A. Hanel, MD, PhD; Henry Woo, MD; Peter A. Rasmussen, MD; L. Nelson Hopkins, MD; Thomas J. Masaryk, MD Cameron G. McDougall, MD

From the Departments of Neurosurgery and Neuroradiology (D.F., H.W., P.A.R., T.J.M.), Cleveland Clinic Foundation, Cleveland, Ohio; the Departments of Neurosurgery and Radiology and the Toshiba Stroke Research Center (E.I.L., R.A.H., L.N.H.), School of Medicine and Biomedical Sciences, State University of New York, and Millard Fillmore Gates Hospital, Kaleida Health, Buffalo, NY; the Departments of Neurosurgery and Neuroradiology (A.S.T., D.B.N., B.A.-K.), University of Wisconsin, Madison; and the Department of Neurosurgery (F.C.A., C.G.M.), Barrow Neurological Institute, Phoenix, Ariz.

Correspondence to David Fiorella, MD, PhD, Cleveland Clinic Foundation, S-80, Departments of Endovascular and Cerebrovascular Neurosurgery, 9500 Euclid Ave, Cleveland, OH 44195. E-mail fioreld{at}ccf.org

Background and Purpose— The current report details our initial periprocedural experience with Wingspan (Boston Scientific/Target), the first self-expanding stent system designed for the treatment of intracranial atheromatous disease.

Methods— All patients undergoing angioplasty and stenting with the Gateway balloon–Wingspan stent system were prospectively tracked.

Results— During a 9-month period, treatment with the stent system was attempted in 78 patients (average age, 63.6 years; 33 women) with 82 intracranial atheromatous lesions, of which 54 were ≥70% stenotic. Eighty-one of 82 lesions were successfully stented (98.8%) during the first treatment session. In 1 case, the stent could not be delivered across the lesion; the patient was treated solely with angioplasty and stented at a later date. Lesions treated involved the internal carotid (n=32; 8 petrous, 10 cavernous, 11 supraclinoid segment, 3 terminus), vertebral (n=14; V4 segment), basilar (n=14), and middle cerebral (n=22) arteries. Mean±SD pretreatment stenosis was 74.6±13.9%, improving to 43.5±18.1% after balloon angioplasty and to 27.2±16.7% after stent placement. Of the 82 lesions treated, there were 5 (6.1%) major periprocedural neurological complications, 4 of which ultimately led to patient death within 30 days of the procedure.

Conclusions— Angioplasty and stenting for symptomatic intracranial atheromatous disease can be performed with the Gateway balloon–Wingspan stent system with a high rate of technical success and acceptable periprocedural morbidity. Our initial experience indicates that this procedure represents a viable treatment option for this patient population.


Key Words: angioplasty • intracranial atheromatous disease • stenting • Wingspan




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