US multicenter experience with the wingspan stent system for the treatment of intracranial atheromatous disease - Periprocedural results

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.