Yavuz Kivilcim, Geyik Serdar, Saatci Isil, Cekirge H Saruhan
Department of Radiology, Hacettepe University Hospitals, Ankara, Turkey.
J Neurosurg. 2008 Sep;109(3):445-53. doi: 10.3171/JNS/2008/109/9/0445.
The WingSpan stent is a new self-expandable neurovascular stent designed for endovascular treatment of intracranial atheromatous lesions. The authors report their experience with the use of this stent for the endovascular treatment of intracranial aneurysms.
Thirty-seven patients with 40 wide-necked intracranial aneurysms were treated using the WingSpan stent. Twenty-two aneurysms (55%) were small and 18 (45%) were large or giant. In all but 4 aneurysms, embolization was completed by packing the aneurysm sac with platinum coils. In 4 dissecting aneurysms that were fusiform or too small and wide necked to be catheterized, the stent was used alone. In these cases, the stent bridged the aneurysm neck to allow for flow redirection and the potential stent-induced endothelization effect.
Follow-up angiograms obtained in 3 of 4 aneurysms, treated with only stent placement, demonstrated aneurysmal thrombosis and parent artery remodeling in 2 patients and moderate decrease in size in 1. Follow-up angiography obtained at 6 months to 1 year in 31 aneurysms after stent-supported coil embolization demonstrated complete occlusion in 23 aneurysms (74.2%) with a progressive thrombosis rate of 66.7% (10 of 15 aneurysms), and a recanalization rate of 16.1%.
In treating wide-necked intracranial aneurysms, the WingSpan Stent System is very flexible, secure, and effective. Its delivery system is very easy and exact in that it exerts higher outward radial force, thus providing an excellent conformability and a strong scaffold to hold the coils in place. It may offer an effective treatment when used alone in some fusiform or very wide-necked, small dissecting aneurysms in which other surgical or endovascular treatment strategies are not deemed feasible.
WingSpan支架是一种新型的自膨胀式神经血管支架，设计用于颅内动脉粥样硬化病变的血管内治疗。作者报告了使用该支架进行颅内动脉瘤血管内治疗的经验。
37例患有40个宽颈颅内动脉瘤的患者接受了WingSpan支架治疗。22个动脉瘤（55%）为小型，18个（45%）为大型或巨大型。除4个动脉瘤外，其余所有动脉瘤均通过用铂金线圈填充瘤腔完成栓塞。在4个梭形或过小且颈宽无法插管的夹层动脉瘤中，单独使用了支架。在这些病例中，支架跨越动脉瘤颈部以实现血流改道，并利用潜在的支架诱导内皮化效应。
仅接受支架置入治疗的4个动脉瘤中的3个进行了随访血管造影，结果显示2例患者的动脉瘤血栓形成和载瘤动脉重塑，1例动脉瘤大小中度缩小。31个动脉瘤在支架辅助弹簧圈栓塞后6个月至1年进行的随访血管造影显示，23个动脉瘤（74.2%）完全闭塞，渐进性血栓形成率为66.7%（15个动脉瘤中的10个），再通率为16.1%。
在治疗宽颈颅内动脉瘤时，WingSpan支架系统非常灵活、安全且有效。其输送系统非常简便且精确，因为它能施加更高的向外径向力，从而提供出色的顺应性和强大的支架以固定弹簧圈。在一些其他手术或血管内治疗策略不可行的梭形或非常宽颈、小型夹层动脉瘤中，单独使用它可能提供有效的治疗方法。
