DynaCT evaluation of in-stent restenosis following Wingspan stenting of intracranial stenosis.

Abstract

To describe the use of DynaCT angiographic imaging for the evaluation of Wingspan in-stent restenosis (ISR). Two patients were treated with Wingspan stenting and percutaneous transluminal angioplasty (Patient 1 had treatment of a severe stenosis of the right middle cerebral artery and patient 2 had severe stenosis of the left intracranial internal carotid artery. Both patients developed ISR and were evaluated with high resolution DynaCT angiographic imaging. DynaCT demonstrated circumferential soft tissue density material distributed within the stent as the cause of the stenosis visualized with conventional angiography. These findings support the hypothesis that ISR is caused by neointimal proliferation, rather than vascular re-coil with stent collapse.