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Outcomes of middle cerebral artery angioplasty and stenting with Wingspan at a high-volume center

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

This study was to investigate the periprocedural stroke rates, safety, and long-term effect of Wingspan stenting for symptomatic severe stenosis of the middle cerebral artery (MCA) at a high-volume center.

Methods

Between July 2007 and April 2013, 196 consecutive patients with severe MCA atherosclerotic stenosis (≥70 %) who were treated with Wingspan stenting were retrospectively studied. All patients had arterial stenosis-related temporary ischemic attack or strokes. The demographic data, cerebral angiography, technical success rate, periprocedural complications, and clinical and imaging follow-up were analyzed.

Results

The successful stenting rate was 98.0 %, and the stenosis rate was improved from pre-stenting (80.6 ± 8.3 %) to post-stenting (15.5 ± 6.8 %). The 30-day periprocedural stroke or death rate was 7.1 %, with a disabling or fatal rate of 2.6 %. The perioprocedural stroke rate was significantly (P < 0.01) greater in the early learning stage (16.0 %) than in the later technical maturation stage (4.1 %). The total periprocedural ischemic and perforator stroke rates were greater in patients with the most stenosis in the distal MCA 1/3 segment (6.8 and 5.7 %, respectively) than in the proximal and middle 2/3 segments (0.9 and 0 %, respectively). The ipsilateral stroke or death rate beyond 30 days (6–69 months, mean 30 ± 16) was 4.8 %, with the 1- and 2-year cumulative stroke rates of 9.6 and 12.1 %, respectively. Imaging follow-up 6–69 months (mean 10.9 ± 8.5) revealed restenosis in 21 cases (20.4 %).

Conclusion

Intracranial stenting of MCA stenoses may have the potential of better clinical outcomes if patients are properly selected and treated by an experienced operator at a high-volume center.

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Author notes

    Authors and Affiliations

    1. Stroke Center, Zhengzhou University Henan Provincial People’s Hospital, Zhengzhou University, 7 Weiwu Road, Zhengzhou, Henan Province, 450003, People’s Republic of China

      Zi-Liang Wang, Tian-Xiao Li, Dong-Yang Cai, Liang-Fu Zhu, Jiang-Yu Xue, Wei-Xing Bai & Zhao-Shuo Li

    2. Department of Medical Research, Shijiazhuang First Hospital, Hebei Medical University, Hebei, People’s Republic of China

      Bu-Lang Gao

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    1. Zi-Liang Wang
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    Correspondence to Tian-Xiao Li.

    Ethics declarations

    We declare that all human studies have been approved by the Ethics Committee of Henan Provincial People’s Hospital and have therefore performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

    Conflict of interest

    We declare that we have no conflict of interest.

    Additional information

    Z-LW and B-LG contributed equally to this work.

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    Wang, ZL., Gao, BL., Li, TX. et al. Outcomes of middle cerebral artery angioplasty and stenting with Wingspan at a high-volume center. Neuroradiology 58, 161–169 (2016). https://doi.org/10.1007/s00234-015-1611-8

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    • DOI: https://doi.org/10.1007/s00234-015-1611-8

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