Wingspan stenting can effectively prevent long-term strokes for patients with severe symptomatic atherosclerotic basilar stenosis

Interv Neuroradiol. 2016 Jun;22(3):318-24. doi: 10.1177/1591019915623797. Epub 2016 Jan 27.


Objective: To investigate the safety and long-term effect of using the Wingspan stent for severe symptomatic atherosclerotic basilar artery stenosis (≥70%).

Materials and methods: Between July 2007 and April 2013, we had 91 consecutive patients (age range 41-82 years old) with symptomatic severe basilar stenosis (70-99%) who underwent Wingspan stenting at our center. All patients had stenosis-related temporary ischemic attack or strokes. We analyzed the demographic data, pre- and post-procedural cerebral angiography, technical success rate, peri-procedural complications, and clinical and imaging follow-ups.

Results: The Wingspan stenting procedure was successful in all patients: The stenosis was reduced from 82.2% ± 5.8% pre-stenting to 15.9% ± 5.7% post-stenting. The 30-day peri-operative rate for stroke or death was 14.3%, which included ischemic stroke in 12 cases (12/91 = 13.2%) and subarachnoid hemorrhage in one case (1/91 = 1.1%), with a fatal or disabling stroke rate of 2.2%. Among the 77 patients with clinical follow-up assessment within 7-60 months (mean 31.3 ± 15.1 months) after stenting, four patients (5.2%) had posterior ischemia, including one patient with disabling ischemic stroke (1.3%) and three patients (3.9%) with temporary ischemic attack. The 2-year cumulative stroke rate was 16% (95% CI: 8.2-23.8%). Among 46 patients with imaging assessments at 3-45 months (mean, 9.5 ± 8.3) post-stenting, six (13.0%) patients had restenosis, including two (2/46 = 4.3%) with symptomatic restenosis.

Conclusions: The benefit of stenting for patients with severe basilar artery stenosis (> 70%) may lie in lowering the long-term fatal and disabling stroke rate; and as long as the peri-operative stroke rate can be kept at a relatively lower level, patients with severe basilar stenosis can benefit from basilar artery stenting.

Keywords: Adverse effects; Wingspan stent; atherosclerotic stenosis; basilar artery; imaging; intracranial stenting; long-term effect; restenosis; stenosis; stenting procedures; stroke; temporary ischemic attack.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cerebral Angiography
  • Female
  • Humans
  • Intracranial Arteriosclerosis / complications*
  • Male
  • Middle Aged
  • Stents*
  • Stroke / etiology*
  • Stroke / prevention & control*
  • Treatment Outcome
  • Vertebrobasilar Insufficiency / complications*