Abstract 126: Wingspan Stent Largest Series Outside SAMMPRIS: Long-term Results
Objective: Intracranial stenosis is a common culprit for stroke which has been traditionally managed with medical therapy. However, recurrent TIA or stroke symptoms often occur despite aggressive management with antiplatelet medications. As such, angioplasty and stenting of intracranial vasculature has become an attractive idea for treatment of intracranial stenosis refractory to medical treatment. Because the SAMMPRIS trial was terminated prematurely, long term data regarding efficacy is lacking. We present the results of our series of 61 patients who underwent Wingspan stent placement for intracranial stenosis and evaluate the short-term and long-term success.
Methods: Sixty-one patients with high-grade, symptomatic intracranial stenosis underwent Wingspan stent embolization at Jefferson Hospital for Neuroscience from August 7, 2006 to July 13, 2011. The clinical charts were reviewed to evaluate presentation, intervention, perioperative course, and outcome.
Results: Our series consisted of 61 patients who received a Wingspan stent for intracranial stenosis(41 male; 20 female; mean age 62.9). Stenotic vessels treated included the internal carotid artery(n=18), middle cerebral artery(n=13), basilar artery(n=15), vertebrobasilar junction(n=2), and vertebral artery(n=13). Failure of stent placement was the only identified intraoperative complications, occurring in 6.6% of procedures. Perioperative complications occurred in 6.6% of patients, and included myocardial infarction(n=1), TIA or stroke without in-stent thrombosis(n=1), TIA or stroke with in-stent thrombosis(n=2), and death(n=2). Mortality rate was 3.3% in the perioperative period. Follow-up data was available for 41(67.2%) patients, with a mean duration of 205 days after intervention. In this follow-up group, 9.8%(n=4) suffered delayed in-stent thrombosis, 3(7.3%) of which suffered new TIAs or stroke. There was 1(2.4%) delayed mortality related to pseudoaneurysm rupture at the site of the stent.
Conclusion: We present the largest series of patients outside of SAMMPRIS to undergo Wingspan stenting for intracranial stenosis. Immediate and long-term follow-up data demonstrates the safety profile of the procedure with efficacy in preventing future strokes. Delayed in-stent thrombosis is the most common risk to observe in this patient population.
- © 2012 by American Heart Association, Inc.