TY - JOUR T1 - Influence of Patient Age and Stenosis Location on Wingspan In-Stent Restenosis JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 23 LP - 27 DO - 10.3174/ajnr.A0869 VL - 29 IS - 1 AU - A.S. Turk AU - E.I. Levy AU - F.C. Albuquerque AU - G.L. Pride, Jr AU - H. Woo AU - B.G. Welch AU - D.B. Niemann AU - P.D. Purdy AU - B. Aagaard-Kienitz AU - P.A. Rasmussen AU - L.N. Hopkins AU - T.J. Masaryk AU - C.G. McDougall AU - D. Fiorella Y1 - 2008/01/01 UR - http://www.ajnr.org/content/29/1/23.abstract 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. ER -