Document Detail


Wingspan Stenting for Intracranial Atherosclerotic Stenosis: Clinical Outcomes and Risk Factors for In-stent Restenosis.
MedLine Citation:
PMID:  23277374     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: Intracranial atherosclerotic stenosis (ICAS) is responsible for 9-37% 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 as well as the clinical outcomes of these patients. RESULTS:: The 30-day TIA/stroke and death rates were 5.3% (95% CI, 0.1% to 10.5%) and 0%, respectively. All patients but one were followed clinically for a mean of 18.9 months (range, 12-23 months). During the period, cumulative TIA/stroke and death rates were 8.1% (95% CI, 1.7% to 14.5%) and 0%, respectively. Only one patient suffered a disabling stroke (subarachnoid hemorrhage), which was associated with retreatment of an ISR using a drug-eluting balloon-expandable stent. Follow-up angiography was available in 69 treated vessels (89.6%) at 3-24 months (median: 12 months). Binary ISR rate was 24.6%, of which 17.6% (3 of 17 cases) were symptomatic. Rapid balloon inflation (95% CI, 5.490 to 530.817) and longer length of stenosis (95% CI, 1.093 to 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.
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 M D; Hyo Suk Nam; Young Dae Kim
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-28
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2013-1-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Neurosurgery, The Catholic University College of Medicine, St. Mary's Hospital, Seoul, South Korea. 2Radiology, Severance Hospital Yonsei University College of Medicine, Seoul, South Korea. 3Radiology, Gangnam Severance Hospital Yonsei University College of Medicine, Seoul, South Korea. 4Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. 5Radiology, The Catholic University College of Medicine, St. Mary's Hospital, Seoul, South Korea. 6Neurology, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea.
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