Influence of patient age and stenosis location on wingspan in-stent restenosis

A. S. Turk, E. I. Levy, F. C. Albuquerque, G. L. Pride, H. Woo, B. G. Welch, D. B. Niemann, P. D. Purdy, B. Aagaard-Kienitz, P. A. Rasmussen, L. N. Hopkins, T. J. Masaryk, C. G. McDougall, David J. Fiorella

Research output: Contribution to journalArticle

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Abstract

BACKGROUND AND PURPOSE: Wingspan is a self-expanding, microcatheter- delivered microstent specifically designed for the treatment of symptomatic intracranial atherosclerotic disease. Our aim was to discuss the effect of patient age and lesion location on in-stent restenosis (ISR) rates after percutaneous transluminal angioplasty and stenting (PTAS) with the Wingspan system. MATERIALS AND METHODS: Clinical and angiographic follow-up results were recorded for all patients from 5 participating institutions. ISR was defined as >50% stenosis within or immediately adjacent (within 5 mm) to the implanted stent and >20% absolute luminal loss. For the present analysis, patients were stratified into younger (≤55 years) and older (>55 years) age groups. RESULTS: ISR occurred at a rate of 45.2% (14/31) in the younger group and 24.2% (15/62) in the older group (odds ratio, 2.6; 95% confidence interval, 1.03-6.5). In the younger group, ISR occurred after treatment of 13/26 (50%) anterior circulation lesions versus only 1/5 (20%) posterior circulation lesions. In the older group, ISR occurred in 9/29 (31.0%) anterior circulation lesions and 6/33 (18.2%) posterior circulation lesions. In young patients, internal carotid artery lesions (10/17 treated, 58.8%), especially those involving the supraclinoid segment (8/9, 88.9%), were very prone to ISR. When patients of all ages were considered, supraclinoid segment lesions had much higher rates of both ISR (66.6% versus 24.4%) and symptomatic ISR (40% versus 3.9%) in comparison with all other locations. CONCLUSION: Post-Wingspan ISR is more common in younger patients. This increased risk can be accounted for by a high prevalence of anterior circulation lesions in this population, specifically those affecting the supraclinoid segment, which are much more prone to ISR and symptomatic ISR than all other lesions.

Original languageEnglish (US)
Pages (from-to)23-27
Number of pages5
JournalAmerican Journal of Neuroradiology
Volume29
Issue number1
DOIs
StatePublished - Jan 2008

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Stents
Pathologic Constriction
Internal Carotid Artery
Angioplasty
Age Groups
Odds Ratio
Confidence Intervals

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Influence of patient age and stenosis location on wingspan in-stent restenosis. / Turk, A. S.; Levy, E. I.; Albuquerque, F. C.; Pride, G. L.; Woo, H.; Welch, B. G.; Niemann, D. B.; Purdy, P. D.; Aagaard-Kienitz, B.; Rasmussen, P. A.; Hopkins, L. N.; Masaryk, T. J.; McDougall, C. G.; Fiorella, David J.

In: American Journal of Neuroradiology, Vol. 29, No. 1, 01.2008, p. 23-27.

Research output: Contribution to journalArticle

Turk, AS, Levy, EI, Albuquerque, FC, Pride, GL, Woo, H, Welch, BG, Niemann, DB, Purdy, PD, Aagaard-Kienitz, B, Rasmussen, PA, Hopkins, LN, Masaryk, TJ, McDougall, CG & Fiorella, DJ 2008, 'Influence of patient age and stenosis location on wingspan in-stent restenosis', American Journal of Neuroradiology, vol. 29, no. 1, pp. 23-27. https://doi.org/10.3174/ajnr.A0869
Turk, A. S. ; Levy, E. I. ; Albuquerque, F. C. ; Pride, G. L. ; Woo, H. ; Welch, B. G. ; Niemann, D. B. ; Purdy, P. D. ; Aagaard-Kienitz, B. ; Rasmussen, P. A. ; Hopkins, L. N. ; Masaryk, T. J. ; McDougall, C. G. ; Fiorella, David J. / Influence of patient age and stenosis location on wingspan in-stent restenosis. In: American Journal of Neuroradiology. 2008 ; Vol. 29, No. 1. pp. 23-27.
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abstract = "BACKGROUND AND PURPOSE: Wingspan is a self-expanding, microcatheter- delivered microstent specifically designed for the treatment of symptomatic intracranial atherosclerotic disease. Our aim was to discuss the effect of patient age and lesion location on in-stent restenosis (ISR) rates after percutaneous transluminal angioplasty and stenting (PTAS) with the Wingspan system. MATERIALS AND METHODS: Clinical and angiographic follow-up results were recorded for all patients from 5 participating institutions. ISR was defined as >50{\%} stenosis within or immediately adjacent (within 5 mm) to the implanted stent and >20{\%} absolute luminal loss. For the present analysis, patients were stratified into younger (≤55 years) and older (>55 years) age groups. RESULTS: ISR occurred at a rate of 45.2{\%} (14/31) in the younger group and 24.2{\%} (15/62) in the older group (odds ratio, 2.6; 95{\%} confidence interval, 1.03-6.5). In the younger group, ISR occurred after treatment of 13/26 (50{\%}) anterior circulation lesions versus only 1/5 (20{\%}) posterior circulation lesions. In the older group, ISR occurred in 9/29 (31.0{\%}) anterior circulation lesions and 6/33 (18.2{\%}) posterior circulation lesions. In young patients, internal carotid artery lesions (10/17 treated, 58.8{\%}), especially those involving the supraclinoid segment (8/9, 88.9{\%}), were very prone to ISR. When patients of all ages were considered, supraclinoid segment lesions had much higher rates of both ISR (66.6{\%} versus 24.4{\%}) and symptomatic ISR (40{\%} versus 3.9{\%}) in comparison with all other locations. CONCLUSION: Post-Wingspan ISR is more common in younger patients. This increased risk can be accounted for by a high prevalence of anterior circulation lesions in this population, specifically those affecting the supraclinoid segment, which are much more prone to ISR and symptomatic ISR than all other lesions.",
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T1 - Influence of patient age and stenosis location on wingspan in-stent restenosis

AU - Turk, A. S.

AU - Levy, E. I.

AU - Albuquerque, F. C.

AU - Pride, G. L.

AU - Woo, H.

AU - Welch, B. G.

AU - Niemann, D. B.

AU - Purdy, P. D.

AU - Aagaard-Kienitz, B.

AU - Rasmussen, P. A.

AU - Hopkins, L. N.

AU - Masaryk, T. J.

AU - McDougall, C. G.

AU - Fiorella, David J.

PY - 2008/1

Y1 - 2008/1

N2 - BACKGROUND AND PURPOSE: Wingspan is a self-expanding, microcatheter- delivered microstent specifically designed for the treatment of symptomatic intracranial atherosclerotic disease. Our aim was to discuss the effect of patient age and lesion location on in-stent restenosis (ISR) rates after percutaneous transluminal angioplasty and stenting (PTAS) with the Wingspan system. MATERIALS AND METHODS: Clinical and angiographic follow-up results were recorded for all patients from 5 participating institutions. ISR was defined as >50% stenosis within or immediately adjacent (within 5 mm) to the implanted stent and >20% absolute luminal loss. For the present analysis, patients were stratified into younger (≤55 years) and older (>55 years) age groups. RESULTS: ISR occurred at a rate of 45.2% (14/31) in the younger group and 24.2% (15/62) in the older group (odds ratio, 2.6; 95% confidence interval, 1.03-6.5). In the younger group, ISR occurred after treatment of 13/26 (50%) anterior circulation lesions versus only 1/5 (20%) posterior circulation lesions. In the older group, ISR occurred in 9/29 (31.0%) anterior circulation lesions and 6/33 (18.2%) posterior circulation lesions. In young patients, internal carotid artery lesions (10/17 treated, 58.8%), especially those involving the supraclinoid segment (8/9, 88.9%), were very prone to ISR. When patients of all ages were considered, supraclinoid segment lesions had much higher rates of both ISR (66.6% versus 24.4%) and symptomatic ISR (40% versus 3.9%) in comparison with all other locations. CONCLUSION: Post-Wingspan ISR is more common in younger patients. This increased risk can be accounted for by a high prevalence of anterior circulation lesions in this population, specifically those affecting the supraclinoid segment, which are much more prone to ISR and symptomatic ISR than all other lesions.

AB - BACKGROUND AND PURPOSE: Wingspan is a self-expanding, microcatheter- delivered microstent specifically designed for the treatment of symptomatic intracranial atherosclerotic disease. Our aim was to discuss the effect of patient age and lesion location on in-stent restenosis (ISR) rates after percutaneous transluminal angioplasty and stenting (PTAS) with the Wingspan system. MATERIALS AND METHODS: Clinical and angiographic follow-up results were recorded for all patients from 5 participating institutions. ISR was defined as >50% stenosis within or immediately adjacent (within 5 mm) to the implanted stent and >20% absolute luminal loss. For the present analysis, patients were stratified into younger (≤55 years) and older (>55 years) age groups. RESULTS: ISR occurred at a rate of 45.2% (14/31) in the younger group and 24.2% (15/62) in the older group (odds ratio, 2.6; 95% confidence interval, 1.03-6.5). In the younger group, ISR occurred after treatment of 13/26 (50%) anterior circulation lesions versus only 1/5 (20%) posterior circulation lesions. In the older group, ISR occurred in 9/29 (31.0%) anterior circulation lesions and 6/33 (18.2%) posterior circulation lesions. In young patients, internal carotid artery lesions (10/17 treated, 58.8%), especially those involving the supraclinoid segment (8/9, 88.9%), were very prone to ISR. When patients of all ages were considered, supraclinoid segment lesions had much higher rates of both ISR (66.6% versus 24.4%) and symptomatic ISR (40% versus 3.9%) in comparison with all other locations. CONCLUSION: Post-Wingspan ISR is more common in younger patients. This increased risk can be accounted for by a high prevalence of anterior circulation lesions in this population, specifically those affecting the supraclinoid segment, which are much more prone to ISR and symptomatic ISR than all other lesions.

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