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Wingspan stenting for intracranial atherosclerotic stenosis: clinical outcomes and risk factors for in-stent restenosis

Authors
 Yong Sam Shin  ;  Byung Moon Kim  ;  Sang Hyun Suh  ;  Pyoung Jeon  ;  Dong Joon Kim  ;  Dong Ik Kim  ;  Bum-soo Kim  ;  Keon Ha Kim  ;  Ji Hoe Heo  ;  Hyo Suk Nam  ;  Young Dae Kim 
Citation
 Neurosurgery, Vol.72(4) : 596-604, 2013 
Journal Title
 Neurosurgery 
ISSN
 0148-396X 
Issue Date
2013
Abstract
BACKGROUND: Intracranial atherosclerotic stenosis (ICAS) is responsible for 9% to 37% of ischemic strokes. OBJECTIVE: To evaluate the clinical outcome and risk factors for in-stent restenosis (ISR) after treatment of ICAS with a Wingspan stent. METHODS: Seventy-seven patients with 79 total target ICAS > 60% (mean, 79.9 ± 8.4%; symptomatic ICAS, 96.2%) underwent attempted treatment with Wingspan stenting between March 2010 and March 2011. A retrospective review of the prospectively registered data was conducted to assess the risk factors for ISR and the clinical outcomes of these patients. RESULTS: The 30-day transient ischemic attack/stroke and death rates were 5.3% (95% confidence interval [CI], 0.1-10.5) and 0%, respectively. All patients but 1 were followed up clinically for a mean of 18.9 months (range, 12-23 months). During the period, cumulative transient ischemic attack/stroke and death rates were 8.1% (95% CI, 1.7-14.5) and 0%, respectively. Only 1 patient suffered a disabling stroke (subarachnoid hemorrhage), which was associated with retreatment of an ISR with a drug-eluting balloon-expandable stent. Follow-up angiography was available in 69 treated vessels (89.6%) at 3 to 24 months (median, 12 months). Binary ISR rate was 24.6%, of which 17.6% (3 of 17 cases) was symptomatic. Rapid balloon inflation (95% CI, 5.490-530.817) and longer length of stenosis (95% CI, 1.093-1.891) were independent risk factors for ISR. CONCLUSION: Wingspan stenting may be effective for appropriately selected ICAS patients. Rapid balloon inflation and longer lengths of stenosis were independent risk factors for ISR.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86788
DOI
10.1227/NEU.0b013e3182846e09
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실)
Yonsei Authors
김동익(Kim, Dong Ik)
김동준(Kim, Dong Joon)
김병문(Kim, Byung Moon)
김영대(Kim, Young Dae)
남효석(Nam, Hyo Suk)
서상현(Suh, Sang Hyun)
허지회(Heo, Ji Hoe)
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