New procedure offers hope to patients at high risk for recurrent stroke

Surgeons at NewYork-Presbyterian Hospital/Weill Cornell Medical Center are the first in the New York City metropolitan area to successfully implant into the brain arteries a new stent specifically designed to treat high-risk stroke patients who have not previously responded to medical therapy.

The Wingspan^TM Stent System is used for those individuals diagnosed with intracranial atherosclerotic disease (ICAD) -- excess plaque buildup in the brain arteries.

The intracranial stenting procedure involves making a small incision in the patient’s femoral artery. The device is threaded through the patient’s vessels to the location of plaque in the cerebral vessel. A balloon is then expanded to crack the plaque and withdrawn, and the stent is inserted and deployed to open the vessel.

"Stents, which are thin, wire-mesh tubes, have long been used to successfully open the carotid arteries in the neck to prevent stroke. Now they are being used in a similar fashion inside the brain," says Dr. Pierre Gobin, professor of radiology and neurological surgery at Weill Medical College of Cornell University and director of the division of interventional neuroradiology at NewYork-Presbyterian/Weill Cornell. "As opposed to carotid stents that are made of stainless steel, this brain stent is designed specifically for the fragile vessels of the brain."

"Recent research has shown that a very large percentage of patients with plaque buildup in their brains’ vessels do not respond to medication," says Dr. Howard A. Riina, associate professor of neurological surgery at Weill Medical College of Cornell University and co-director of the division of interventional neuroradiology at NewYork-Presbyterian/Weill Cornell. "Without any intervention, these patients have a significant chance of having another stroke within a year."

According to the American Stroke Association, there are about 700,000 strokes cases every year. About 10 percent of stokes are due to problems associated with ICAD.

The device, called the Wingspan^TM Stent System with Gateway^TM PTA Balloon Catheter, is manufactured by Boston Scientific of Natick, Mass. It is the only device of its kind available in the U.S. The FDA granted Humanitarian Device Exemption (HDE) status in August 2005 to Wingspan based on a multi-center study in Europe and Asia. The study enrolled patients who had a stroke caused by an intracranial lesion and for whom medical treatment failed to prevent another stroke. The device had a procedural success rate of 98 percent.