Wingspan stent for high-grade symptomatic vertebrobasilar artery atherosclerotic stenosis

This study was designed to present the treatment outcomes with Wingspan stent angioplasty of high-grade intracranial vertebrobasilar artery (VBA) stenosis in symptomatic patients.

Between 2007 and 2010, the records of 30 patients with 31 intracranial high-grade VBA stenoses (all ≥ 70%) who underwent elective stenting due to the failure of medical therapy were retrospectively reviewed. Clinical evaluation was performed based on the modified Rankin scale and the National Institutes of Health Stroke Scale.

In all cases, the stent deployment was technically successful. The mean stenosis decreased significantly from 82.28 ± 8.02% (range, 72-99%) to 11.18 ± 7.28% (range, 0-25%) after stent-assisted angioplasty (P < 0.05). Periprocedure complications occurred in 3 (10%) of 30 patients; there were 2 cases of perforator strokes and 1 case of transient flow insufficiency with stent overlap. Clinical follow-up (mean, 17.81 ± 11.49 months; range, 5-40 months) was available for 27 patients, and angiographic follow-up (mean, 9.95 ± 5.74 months, range, 5-20 months) was available for 19 patients. Only one case demonstrated recurrent symptoms with restenosis (≥ 50%). There were no recurrent ischemic events and no cases of restenosis in the other patients.

According to our data, the Wingspan stent for symptomatic intracranial VBA stenoses is a safe and efficacious treatment alternative in cases with recurrent symptoms despite medical therapy. However, the improvement of outcome requires the reduction in the rate of procedure-related complications and long-term outcomes still have to be demonstrated.