Clinical Study Of Wingspan Stents For Symptomatic Atherosclerotic Stenosis Of The Basilar Artery

Cerebrovascular disease is one of the most serious disease in the worldtoday.It threats human health.According to the relevantstatistics,cerebrovascular diseases have become the third largest killerdiseases,the majority of illness occur in the elderly sick people,includingischemic stroke (cerebral ischemic stroke, CIS) which occupies a largeproportion of patients,society and the patient’s family were brought a heavyburden.In ischemic stroke (CIS) patients,10%-29%of the stroke is due tointracranial arterial stenosis caused by atherosclerosis.Basilar artery was mergedby the left vertebral artery and the right vertebral artery,go in the pontinebase,along issue multiple pontine perforating artery.Basilar artery stenosis or occlusion is the more serious clinical outcomes,it can cause brain steminfarction.It is such a high mortality and morbidity in patients.At present, basilarartery stenosis is treated mainly by drug therapy and intracranial stenting.Theformer is taking anti-platelet drugs and control the risk factors such ashypertension,diabetes,hyperlipidemia,etc.;latter mainly through surgicalintervention.For the effect of basilar artery stenosis with Wingspan stenting,weneed long-term follow-up of patients and clinical observation.Objective: The purpose of this study is to assess the efficacy andfeasibility of Wingspan stents for symptomatic atherosclerotic stenosis of thebasilar artery.Method: Clinical data of40patients with symptomatic atheroscleroticstenoses in the basilar artery were analyzed retrospectively. The operativesuccessful rate，the degree of stenosis,perioperative complications and theresults of clinical and imaging follow-up were analyzed. Stenting perioperative(after30days),6months after surgery,12months after surgery the patient mRsscore.After6months or12months,through CTA or DSA imaging we observethe presence of the stent restenosis.Results: The technical success rate was95.35%. The overall incidence ofadverse events during the perioperative period (30days) was20.0%(eight of40patients), which included five ischemic infarct complications,one hemorrhagiccomplication and two transient ischemic attacks.There were four patients withdisabling events and death.The rate of procedure-related complications is15%,morbidity and fatality rate is10%.Thirty-six patients(92.3%) wereavailable for a clinical follow up. The mean follow-up period was36.3months(range12–75months). Seventeen patients (47.2%) were available for follow-upimaging with DSA or CTA. The mean imaging follow-up period was9.4 months (range4–41months). Symptomatic in-stent restenosis (ISR) wasdocumented in two(11.76%) of these patients. Three ischemic events occurredduring the follow-up period in12months, which were one transient ischemicattack,one symptomatic ISR and one new ischemic infarct.Two(5.56%) patients’occurrence of ischemic signs and symptoms related to the treated stenosis duringfollow-up.Conclusions: For severe refractory atherosclerotic stenosis of the basilarartery,Wingspan stents were an effective technique.But we should be cautious toselect appropriate cases for stent treatment.We should also strictly controlindications,distinguish patients’ pathogenesis,master the right time fortreatment.According to the site of vascular lesions and length,we select theappropriate stent.We must pay attention to the prevention of perioperativecomplications and the clinical follow-up.