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Abstract

The safety and performance of angioplasty using a normal-sized Gateway™ balloon and Wingspan™ stent for intracranial atherosclerotic stenosis were assessed. Seventy-two patients with intracranial stenosis (≥ 50%) were treated using an undersized (group U) or normal-sized (group N) Gateway™ balloon and a Wingspan™ stent. All patients were successfully stented. Stenosis improved from 74.2% before treatment to 23.8% immediately after treatment in group U and from 70.9% to 20.1% in group N. The two groups had similar rates of major periprocedural neurological complications (9.0% overall), none of which led to death. Residual stenosis at follow-up was 40.8% and 32.5% in groups U and N, respectively. In-stent re-stenosis (ISR) was significantly less frequent in group N (22.0%) than in group U (33.3%). It is concluded that use of a normal-sized Gateway™ balloon and Wingspan™ stent appears to be safe, to have a high rate of technical success, good immediate post-operative results and a low ISR rate.

Keywords

Gateway™balloon catheter Wingspan™stent Angioplasty Intracranial atherosclerotic stenosis Stroke Safety Performance

References

Wong

Huang

Gao

: Intracranial stenosis in Chinese patients with acute stroke. Neurology 1998; 50: 812–813.

Chimowitz

Lynn

Howlett-Smith

: Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. N Engl J Med 2005; 352: 1305–1316.

Chimowitz

Kokkinos

Strong

: The Warfarin–Aspirin Symptomatic Intracranial Disease Study. Neurology 1995; 45: 1488–1493.

Mazighi

Tanasescu

Ducrocq

: Prospective study of symptomatic atherothrombotic intracranial stenoses: The GESICA study. Neurology 2006; 66: 1187–1191.

Fiorella

Levy

Turk

: US multicenter experience with the Wingspan stent system for the treatment of intracranial atheromatous disease: Periprocedural results. Stroke 2007; 38: 881–887.

Bose

Hartmann

Henkes

: A novel, self-expanding, nitinol stent in medically refractory intracranial atherosclerotic stenoses: The Wingspan study. Stroke 2007; 38: 1531–1537.

Henkes

Miloslavski

Lowens

: Treatment of intracranial atherosclerotic stenoses with balloon dilatation and self-expanding stent deployment (WingSpan). Neuroradiology 2005; 47: 222–228.

Levy

Turk

Albuquerque

: Wingspan in-stent restenosis and thrombosis: Incidence, clinical presentation, and management. Neurosurgery 2007; 61: 644–651.

Turk

Levy

Albuquerque

: Influence of patient age and stenosis location on Wingspan in-stent restenosis. AJNR Am J Neuroradiol 2008; 29: 23–27.

10.

Samuels

Joseph

Lynn

: A standardized method for measuring intracranial arterial stenosis. AJNR Am J Neuroradiol 2000; 21: 643–646.

11.

Kasner

Chimowitz

Lynn

: Predictors of ischemic stroke in the territory of a symptomatic intracranical arterial stenosis. Circulation 2006; 113: 555–563.

12.

Amarenco

Bogousslavsky

Callahan

: High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med 2006; 355: 549–559.

13.

PROGRESS Collaborative Group: Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6,105 individuals with previous stroke or transient ischaemic attack. Lancet 2001; 358: 1033–1041.

14.

Fiorella

Levy

Turk

: Target lesion revascularization after Wingspan: Assessment of safety and durability. Stroke 2009; 40: 106–110.

15.

SSYLVIA Study Investigators: Stenting of Symptomatic Atherosclerotic Lesions in the Vertebral or Intracranial Arteries (SSYLVIA): Study results. Stroke 2004; 35: 1388–1392.

16.

Fiorella

Chow

Anderson

: A 7-year experience with balloon-mounted coronary stents for the treatment of symptomatic vertebrobasilar intracranial atheromatous disease. Neurosurgery 2007; 61: 236–243.

Treatment of Symptomatic Intracranial Atherosclerotic Stenosis with a Normal-Sized Gateway™ Balloon and Wingspan™ Stent

Abstract

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