Division of Cerebrovascular and Endovascular Neurosurgery, Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio, USA.
J Neurointerv Surg. 2009 Dec;1(2):165-7. doi: 10.1136/jnis.2009.000497.
The impact of the Warfarin and Aspirin for Symptomatic Intracranial Disease (WASID) data is described in combination with the commercial release of the Wingspan stenting system on the frequency of neurointervention for the treatment of symptomatic intracranial atherosclerotic disease (ICAD) in a tertiary care center.
Endovascular case logs were reviewed from April 2004 to July 2007. The total number of intracranial neurointerventions and the number of neurointerventions (percutaneous transluminal angioplasty alone (PTA) or with stenting (PTAS)) performed for symptomatic ICAD were calculated. The time period evaluated was divided into two equal 19.5-month epochs representing the time periods before and after the availability of the Wingspan system.
The frequency of neurointerventions for ICAD increased by 763%, from seven of 354 total cases (2%) to 56 of 367 total cases (15.3%) (p<0.001) after the Wingspan system became available. The increase in intracranial PTAS volume occurred immediately and was stable throughout the "Wingspan era".
The publication of the WASID trial results combined with the availability of the Wingspan stent system led to a marked increase in the frequency of neurointervention for symptomatic ICAD at our institution. The adoption of this technology occurred without direct evidence that PTAS with Wingspan is superior to traditional medical therapy. These findings underscore the need for a randomized trial of stenting and medical therapy for the treatment of this disease process.
WASID 数据的影响，结合 Wingspan 支架系统的商业发布，对三级护理中心治疗症状性颅内动脉粥样硬化性疾病（ICAD）的神经介入治疗频率产生了影响。
回顾 2004 年 4 月至 2007 年 7 月的血管内病例记录。计算了颅内神经介入的总次数和因症状性 ICAD 进行的神经介入（单纯经皮腔内血管成形术（PTA）或支架置入术（PTAS））次数。评估的时间段分为两个相等的 19.5 个月的时期，代表 Wingspan 系统可用之前和之后的时间段。
Wingspan 系统可用后，ICAD 的神经介入频率增加了 763%，从 354 例总病例中的 7 例（2%）增加到 367 例总病例中的 56 例（15.3%）（p<0.001）。颅内 PTAS 量的增加是立即发生的，并且在“Wingspan 时代”一直保持稳定。
WASID 试验结果的发表以及 Wingspan 支架系统的可用性，导致我们机构治疗症状性 ICAD 的神经介入频率显著增加。这项技术的采用没有直接证据表明 Wingspan 支架置入术优于传统的药物治疗。这些发现强调了对这种疾病过程进行支架置入术和药物治疗的随机试验的必要性。
