US multicenter experience with the Wingspan stent system for the treatment of intracranial atheromatous disease: Periprocedural results

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

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)881-887
Number of pages7
JournalStroke
Volume38
Issue number3
DOIs
StatePublished - Mar 1 2007
Externally publishedYes

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Stents
Angioplasty
Therapeutics
Balloon Angioplasty
Pathologic Constriction
Arteries
Morbidity
Population

Keywords

  • Angioplasty
  • Intracranial atheromatous disease
  • Stenting
  • Wingspan

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

US multicenter experience with the Wingspan stent system for the treatment of intracranial atheromatous disease : Periprocedural results. / Fiorella, David; Levy, Elad I.; Turk, Aquilla S.; Albuquerque, Felipe C.; Niemann, David B.; Aagaard-Kienitz, Beverly; Hanel, Ricardo A.; Woo, Henry; Rasmussen, Peter A.; Hopkins, L. Nelson; Masaryk, Thomas J.; McDougall, Cameron.

In: Stroke, Vol. 38, No. 3, 01.03.2007, p. 881-887.

Research output: Contribution to journalArticle

Fiorella, D, Levy, EI, Turk, AS, Albuquerque, FC, Niemann, DB, Aagaard-Kienitz, B, Hanel, RA, Woo, H, Rasmussen, PA, Hopkins, LN, Masaryk, TJ & McDougall, C 2007, 'US multicenter experience with the Wingspan stent system for the treatment of intracranial atheromatous disease: Periprocedural results', Stroke, vol. 38, no. 3, pp. 881-887. https://doi.org/10.1161/01.STR.0000257963.65728.e8
Fiorella, David ; Levy, Elad I. ; Turk, Aquilla S. ; Albuquerque, Felipe C. ; Niemann, David B. ; Aagaard-Kienitz, Beverly ; Hanel, Ricardo A. ; Woo, Henry ; Rasmussen, Peter A. ; Hopkins, L. Nelson ; Masaryk, Thomas J. ; McDougall, Cameron. / US multicenter experience with the Wingspan stent system for the treatment of intracranial atheromatous disease : Periprocedural results. In: Stroke. 2007 ; Vol. 38, No. 3. pp. 881-887.
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abstract = "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.",
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