Comparativ analysis of the stenting treatment for symptomatic intracranial arterial stenosis with ba

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  Objective: By retrospectively analyzing the stenting treatment for 88 patients with symptomatic intracranial arterrial stennosis, to compare the predominance and shortage of both balloon-expandable stent vs the Wingspan stent system.Material and Methods: Eighty-eight patients (mean age 66.42 years; 33 male and 15 female patients) with symptomatic intracranial atheromatous stenosis (≥ 70%) were treated with the stent placement.All lesions treated involved the internal carotid artery (n=16), middle cerebral artery (n=28), V4 segment vertebral artery(n=25), basilar artery (n=19).Result: All 63 lesions with Gateway balloon-Wingspan system involved the internal carotid artery (n=12), middle cerebral artery (n=22), V4 segment vertebral artery(n=15), basilar artery (n=14).Sixty-two lesions were successfully treated with the deployment of the Wingspan stent.One case failed because of intracranial hemorrhage during the operation.The successful rate of stenting is 98.0%(62/63).And mean pretreatment stenosis was 82.3 ± 9.2%, improving to 23 ± 11.2% after stent placement.During the perioperation period of one month, 1 patient died of postprocedural hyper-perfusion, one with ischemic stroke during the operating day, one with Homer syndrome attack at the 11th day.The hemorrhage complication rate is 3.2% (2/63) , the ischemic complication rate is 3.2% (2/63) , and the severe stroke or mortality is 1.6% (1/63).All 25 lesions with balloon-expandable stent involved the internal carotid artery (n=4), middle cerebral artery (n=6), V4 segment vertebral artery(n=10), basilar artery (n=5).Three cases witn lesions in the anterocirculation failed because of unsuccessful targenting of stent.The successful rate of stenting is 88.0% (22/25).And mean pretreatment stenosis was 82%, improving to 14% after stent placement.During the perioperation period of one month, 2 cases with hemorrhage complication and the rate is 8% (2/25).One died of subdural hemorrhage and the other recovered.one with ischemic stroke during the operating day and the the ischemic complication rate is 4% (1/25) , and the severe stroke or mortality is 4% (1/25).Conclusion: the nitinol stent is more flexible than balloon-mounted stents.The technical success rate is higher and the complication rate is lower.But there is higher remnant stenosis because of insufficent radial force and the improvement is essensial.
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