SAN ANTONIO — The Gateway balloon-Wingspan stent system was an effective and safe treatment option for patients with intracranial lesions with more than 50% stenosis, Dr. R. Charles Callison, Jr., said at the annual International Stroke Conference.
Dr. Callision, of the division of interventional neuroradiology at the University of Iowa, Iowa City, used a comprehensive database of all patients undergoing endovascular treatment of symptomatic intracranial atheromatous disease (sICAD) with the Wingspan stent system during December 2005–July 2009. In all, 110 patients with 138 lesions were treated. Greater than 50% stenosis occurred in 50 lesions, followed by 70%–80% stenosis for 48 lesions, and 50%–69% for 37 lesions.
Technical success was achieved in 99% of lesions. There were two failures to cross a balloon or stent. Acute in-stent thrombosis was noted periprocedurally in 11% of cases, all of which were successfully treated with intravenous tirofiban.
The combined major stroke and death rate in the first 30 days—a coprimary end point—was 5.5% (mortality 1.8%). The rate of ipsilateral stroke and death after 30 days—a coprimary end point—was 1.8% (no mortality). Eight minor ischemic events occurred; all were transient ischemic attacks.
On angiography, the initial mean stenosis rate was 77%. The postprocedure stenosis rate was 18% and 19% of lesions required post dilation.
Dr. Callison reported that he has no relevant financial relationships. One of his coinvestigators is a consultant for Boston Scientific, maker of the Wingspan stent.