Intracranial Angioplasty with Gateway-Wingspan System for Atherosclerotic Stenosis: A Meta-analysis of Single rate_Chinese Journal of Evidence-Based Medicine

Authors：

 YINRong ¹ , LIUZhao ¹ , ZHANGGuo-zhen ¹ , CHENLi-pin ¹ , CAOLi ¹ , SHIXiang-qun ¹ , HONGBo ² ,  LIUJian-min ²

1. Department of Neurology, The General Hospital of Lanzhou Military Command of the Chinese People's Liberation Army, Lanzhou 730050, China;
2. Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;

Corresponding author：

LIUJian-min, Email: Liu118@vip.163.com

Keywords：

Atherosclerosis; Intracranial artery; Wingspan; Meta-analysis

DOI：

10.7507/1672-2531.20150051

Video：

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Objective To systematically review the safety and validity of the treatment of intracranial atherosclerosis diseases (ICAD) by using Wingspan stents, and to provide the reference for clinical practice and research. Methods Databases such as the PubMed, The Cochrane Library, EMbase, Cochrane Central Register of Controlled Trials, CBM, CNKI and VIP were searched for studies concerning the safety and validity of the treatment of intracranial atherosclerosis diseases (ICAD) by using Wingspan stents from January 1^st, 2005 to January 10^th, 2014. Randomized controlled trials (RCTs), non-randomized controlled trials, case-control studies, cohort studies and case series were all included. Two reviewers independently screened literature according to inclusion and exclusion criteria, extracted data. Then, meta-analysis was performed by using the R software. Results A total of 34 studies (2 RCTs, 22 cohort studies, and 10 case-control studies) involving 2 511 patients were included. The results of meta-analysis showed that:operation success rates was 96.75% (95%CI 95.82% to 97.48%), 30 day rates of the end point events was 8.75% (95%CI 7.61% to 10.04%), 1 year rates of the end point events was 13% (95%CI 11.47% to 14.70%), total mortality was 2.98% (95%CI 2.16% to 4.10%), incidence of in-stent restenosis was 21.76% (95%CI 18.27% to 25.71%), the ratio of the patients with symptomatic restenosis and total patients was 6.50% (95%CI 4.89% to 8.60%), and the ratio of the patients with symptomatic restenosis and total patients with restenosis was 26.06% (95%CI 19.94% to 33.29%). Conclusion Current evidence shows that treatment of ICAD by using Wingspan stents is effective and safe. However, this conclusion should be approved by further higher quality RCTs.

Citation： YINRong, LIUZhao, ZHANGGuo-zhen, CHENLi-pin, CAOLi, SHIXiang-qun, HONGBo, LIUJian-min. Intracranial Angioplasty with Gateway-Wingspan System for Atherosclerotic Stenosis: A Meta-analysis of Single rate. Chinese Journal of Evidence-Based Medicine, 2015, 15(3): 295-304. doi: 10.7507/1672-2531.20150051 Copy

1.	Derdeyn CP, Chimowitz MI, Lynn MJ, et al. Aggressive medical treatment with or without stenting in high-risk patients with intracranial artery stenosis (SAMMPRIS):the final results of a randomised trial. Lancet, 2014, 383(9914):333-341.
2.	Chimowitz MI, Lynn MJ, Derdeyn CP, et al. Stenting versus aggressive medical therapy for intracranial arterial stenosis. N Engl J Med Overseas Ed, 2011, 365(11):993-1003.
3.	Chimowitz MI, Lynn MJ, Howlett-Smith H, et al. Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. N Engl J Med Overseas Ed, 2005, 352(13):1305-1316.
4.	方向华. 中国卒中的流行现状及其影响因素. 中国脑血管病杂志, 2004, (5):233-237.
5.	Zaidat OO, Klucznik R, Alexander MJ, et al. The NIH registry on use of the Wingspan stent for symptomatic 70-99% intracranial arterial stenosis. Neurology, 2008, 70(17):1518-1524.
6.	Fiorella D, Levy EI, Turk AS, et al. US multicenter experience with the wingspan stent system for the treatment of intracranial atheromatous disease:periprocedural results. Stroke, 2007, 38(3):881-887.
7.	Li J, Zhao ZW, Gao GD, et al. Wingspan stenting with modified predilation for symptomatic middle cerebral artery stenosis. Catheter Cardiovasc Interv, 2011, 78(2):286-293.
8.	Fiorella DJ, Turk AS, Levy EI, et al. U.S. Wingspan Registry:12-month follow-up results. Stroke, 2011, 42(7):1976-1981.
9.	Gandini R, Chiaravalloti A, Pampana E, et al. Intracranial atheromatous disease treatment with the Wingspan stent system:evaluation of clinical, procedural outcome and restenosis rate in a single-center series of 21 consecutive patients with acute and mid-term results. Clin Neurol Neurosurg, 2013, 115(6):741-747.
10.	Yu SC, Leung TW, Lee KT, et al. Angioplasty and stenting of intracranial atherosclerosis with the Wingspan system:1-year clinical and radiological outcome in a single Asian center. J Neurointerv Surg, 2014,6(2):96-102.
11.	Nahab F, Lynn MJ, Kasner SE, et al. Risk factors associated with major cerebrovascular complications after intracranial stenting. Neurology, 2009, 72(23):2014-2019.
12.	Turk AS, Levy EI, Albuquerque FC, et al. Influence of patient age and stenosis location on wingspan in-stent restenosis. AJNR Am J Neuroradiol, 2008, 29(1):23-27.
13.	Levy EI, Turk AS, Albuquerque FC, et al. Wingspan in-stent restenosis and thrombosis:incidence, clinical presentation, and management. Neurosurgery, 2007, 61(3):644-651.
14.	Jiang WJ, Yu W, Du B, et al. Outcome of patients with >/=70% symptomatic intracranial stenosis after Wingspan stenting. Stroke, 2011, 42(7):1971-1975.
15.	Bose A, Hartmann M, Henkes H, et al. A novel, self-expanding, nitinol stent in medically refractory intracranial atherosclerotic stenoses:the Wingspan study. Stroke, 2007, 38(5):1531-1537.
16.	Guo XB, Ma N, Hu XB, et al. Wingspan stent for symptomatic M1 stenosis of middle cerebral artery. Eur J Radiol, 2011, 80(3):e356-360.
17.	Lee JH, Yun JK, Kim DW, et al. Clinical and angiographic outcomes of wingspan stent placement for treatment of symptomatic intracranial stenosis:single center experience with 19 cases. J Cerebrovasc Endovasc Neurosurg, 2012, 14(3):157-163.
18.	Zhao ZW, Deng JP, He SM, et al. Intracranial angioplasty with Gateway-Wingspan system for symptomatic atherosclerotic stenosis:preliminary results of 27 Chinese patients. Surgical neurology, 2009, 72(6):607-611.
19.	Costalat V, Maldonado IL, Vendrell JF, et al. Endovascular treatment of symptomatic intracranial stenosis with the Wingspan stent system and Gateway PTA balloon:a multicenter series of 60 patients with acute and midterm results. J Neurosurg, 2011, 115(4):686-693.
20.	Lanfranconi S, Bersano A, Branca V, et al. Stenting for the treatment of high-grade intracranial stenoses. J Neurol, 2010, 257(11):1899-1908.
21.	Li J, Zhao ZW, Gao GD, et al. Wingspan stent for high-grade symptomatic vertebrobasilar artery atherosclerotic stenosis. Cardiovasc Intervent Radiol, 2012, 35(2):268-278.
22.	Yue X, Yin Q, Xi G, et al. Comparison of BMSs with SES for symptomatic intracranial disease of the middle cerebral artery stenosis. Cardiovasc Intervent Radiol, 2011, 34(1):54-60.
23.	Shin YS, Kim BM, Suh SH, et al. Wingspan stenting for intracranial atherosclerotic stenosis:clinical outcomes and risk factors for in-stent restenosis. Neurosurgery, 2013, 72(4):596-604.
24.	Zhang L, Huang Q, Zhang Y, et al. A single-center study of Wingspan stents for symptomatic atherosclerotic stenosis of the middle cerebral artery. J Clin Neurosci, 2013, 20(3):362-366.
25.	Henkes H, Miloslavski E, Lowens S, et al. Treatment of intracranial atherosclerotic stenoses with balloon dilatation and self-expanding stent deployment (WingSpan). Neuroradiology, 2005, 47(3):222-228.
26.	Wolfe TJ, Fitzsimmons BF, Hussain SI, et al. Long term clinical and angiographic outcomes with the Wingspan stent for treatment of symptomatic 50-99% intracranial atherosclerosis:single center experience in 51 cases. J Neurointerv Surg, 2009, 1(1):40-43.
27.	Tarlov N, Jahan R, Saver JL, et al. Treatment of high risk symptomatic intracranial atherosclerosis with balloon mounted coronary stents and Wingspan stents:single center experience over a 10 year period. J Neurointerv Surg, 2012, 4(1):34-39.
28.	Samaniego EA, Tari-Capone F, Linfante I, et al. Wingspan experience in the treatment of symptomatic intracranial atherosclerotic disease after antithrombotic failure. J Neurointerv Surg, 2013, 5(4):302-305.
29.	张磊, 黄清海, 张永巍, 等. Wingspan支架治疗大脑中动脉症状性粥样硬化性狭窄. 中华神经外科杂志, 2012, 28(5):435-439.
30.	梁建峰, 何伟文, 伍健伟. Wingspan支架治疗后循环症状性颅内动脉狭窄的疗效. 中国老年学杂志, 2013, 33(12):2787-2788.
31.	罗望池, 李贵福, 李铁林, 等. Wingspan支架治疗症状性颅内动脉狭窄的疗效及随访. 介入放射学杂志, 2011, 20(7):513-517.
32.	马敏敏, 殷勤, 徐格林, 等. Wingspan支架治疗症状性颅内动脉狭窄术后再狭窄的相关因素分析. 中华医学杂志, 2011, 91(19):1303-1307.
33.	李天晓, 李钊硕, 王子亮, 等. Wingspan支架治疗症状性颅内动脉粥样硬化严重狭窄的临床研究. 中华放射学杂志, 2010, 44(9):969-974.
34.	许斌, 史怀璋, 徐善才, 等. Wingspan支架治疗症状性椎动脉颅内段和基底动脉狭窄的临床观察. 中华神经外科杂志, 2012, 28(12):1226-1229.
35.	杨志刚, 田春鸥, 张磊, 等. Wingspan支架治疗重度症状性颅内椎动脉粥样硬化性狭窄的疗效评价. 中国脑血管病杂志, 2013, 10(7):342-347, 364.
36.	李钊硕, 李天晓, 王子亮, 等. 单中心颅内动脉狭窄Wingspan支架成形术中及术后短期并发症分析. 中华放射学杂志, 2013, 47(2):166-171.
37.	高红华, 高连波. 支架成形术及药物治疗症状性大脑中动脉狭窄的随机对照研究. 介入放射学杂志, 2013, 22(2):89-92.
38.	Holmstedt CA, Turan TN, Chimowitz MI. Atherosclerotic intracranial arterial stenosis:risk factors, diagnosis, and treatment. Lancet Neurol, 2013, 12(11):1106-1114.
39.	Yang F, Liu L, Li M, et al. Pattern of cerebrovascular atherosclerotic stenosis in older Chinese patients with stroke. J Clin Neurosci, 2013, 20(7):979-983.
40.	Pu Y, Liu L, Wang Y, et al. Geographic and sex difference in the distribution of intracranial atherosclerosis in China. Stroke, 2013, 44(8):2109-2114.
41.	Gates L, Indes J. New treatment of iliac artery disease:focus on the Absolute Pro(R) Vascular Self-Expanding Stent System. Medical Devices (Auckland, N.Z.), 2013, 6:147-150.
42.	Vajda Z, Schmid E, Guthe T, et al. The modified Bose method for the endovascular treatment of intracranial atherosclerotic arterial stenoses using the Enterprise stent. Neurosurgery, 2012, 70(1):91-101.
43.	Chimowitz MI, Lynn MJ, Turan TN, et al. Design of the stenting and aggressive medical management for preventing recurrent stroke in intracranial stenosis trial. J Stroke Cerebrovasc Dis, 2011, 20(4):357-368.
44.	Zaidat OO, Castonguay AC, Fitzsimmons BF, et al. Design of the Vitesse Intracranial Stent Study for Ischemic Therapy (VISSIT) trial in symptomatic intracranial stenosis. J Stroke Cerebrovasc Dis, 2013, 22(7):1131-1139.
45.	A Feasibility Study of the Cordis Neurovascular Self Expanding Stent System in Intracranial Arteries. Available at:http://clinicaltrials.gov/ct2/show/NCT00349908.
46.	An International Registry of the Wingspan^TM Stent System for the Treatment of Intracranial Atherosclerotic Stenosis (IRISS). Available at:http://clinicaltrials.gov/ct2/show/NCT00929383.
47.	China Angioplasty & Stenting for Symptomatic Intracranial Severe Stenosis (CASSISS). Available at:http://clinicaltrials.gov/ct2/show/NCT01763320.
48.	Clinical Registration Trial of Intracranial Stenting for Patients With Symptomatic Intracranial Artery Stenosis(CRTICAS). Available at:http://clinicaltrials.gov/ct2/show/NCT01994161.
49.	Efficacy and Safety of Stent Implantation in Symptomatic Extra-and Intracranial Artery Stenosis (ESSCAS). Available at:http://clinicaltrials.gov/ct2/show/NCT00691314.
50.	Registry Study of Stenting for Symptomatic Intracranial Artery Stenosis in China. Available at:http://clinicaltrials.gov/ct2/show/NCT01968122.
51.	Stenting for Symptomatic Intracranial Artery Stenosis Registry in China. Available at:http://clinicaltrials.gov/ct2/show/NCT01830413.
52.	Wingspan Stenting for Symptomatic Severe Stenosis of Intracranial Atherosclerosis Registry in China (WingspanSSIR). Available at:http://clinicaltrials.gov/ct2/show/NCT00685308.

1. Derdeyn CP, Chimowitz MI, Lynn MJ, et al. Aggressive medical treatment with or without stenting in high-risk patients with intracranial artery stenosis (SAMMPRIS):the final results of a randomised trial. Lancet, 2014, 383(9914):333-341.
2. Chimowitz MI, Lynn MJ, Derdeyn CP, et al. Stenting versus aggressive medical therapy for intracranial arterial stenosis. N Engl J Med Overseas Ed, 2011, 365(11):993-1003.
3. Chimowitz MI, Lynn MJ, Howlett-Smith H, et al. Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. N Engl J Med Overseas Ed, 2005, 352(13):1305-1316.
4. 方向华. 中国卒中的流行现状及其影响因素. 中国脑血管病杂志, 2004, (5):233-237.
5. Zaidat OO, Klucznik R, Alexander MJ, et al. The NIH registry on use of the Wingspan stent for symptomatic 70-99% intracranial arterial stenosis. Neurology, 2008, 70(17):1518-1524.
6. Fiorella D, Levy EI, Turk AS, et al. US multicenter experience with the wingspan stent system for the treatment of intracranial atheromatous disease:periprocedural results. Stroke, 2007, 38(3):881-887.
7. Li J, Zhao ZW, Gao GD, et al. Wingspan stenting with modified predilation for symptomatic middle cerebral artery stenosis. Catheter Cardiovasc Interv, 2011, 78(2):286-293.
8. Fiorella DJ, Turk AS, Levy EI, et al. U.S. Wingspan Registry:12-month follow-up results. Stroke, 2011, 42(7):1976-1981.
9. Gandini R, Chiaravalloti A, Pampana E, et al. Intracranial atheromatous disease treatment with the Wingspan stent system:evaluation of clinical, procedural outcome and restenosis rate in a single-center series of 21 consecutive patients with acute and mid-term results. Clin Neurol Neurosurg, 2013, 115(6):741-747.
10. Yu SC, Leung TW, Lee KT, et al. Angioplasty and stenting of intracranial atherosclerosis with the Wingspan system:1-year clinical and radiological outcome in a single Asian center. J Neurointerv Surg, 2014,6(2):96-102.
11. Nahab F, Lynn MJ, Kasner SE, et al. Risk factors associated with major cerebrovascular complications after intracranial stenting. Neurology, 2009, 72(23):2014-2019.
12. Turk AS, Levy EI, Albuquerque FC, et al. Influence of patient age and stenosis location on wingspan in-stent restenosis. AJNR Am J Neuroradiol, 2008, 29(1):23-27.
13. Levy EI, Turk AS, Albuquerque FC, et al. Wingspan in-stent restenosis and thrombosis:incidence, clinical presentation, and management. Neurosurgery, 2007, 61(3):644-651.
14. Jiang WJ, Yu W, Du B, et al. Outcome of patients with >/=70% symptomatic intracranial stenosis after Wingspan stenting. Stroke, 2011, 42(7):1971-1975.
15. Bose A, Hartmann M, Henkes H, et al. A novel, self-expanding, nitinol stent in medically refractory intracranial atherosclerotic stenoses:the Wingspan study. Stroke, 2007, 38(5):1531-1537.
16. Guo XB, Ma N, Hu XB, et al. Wingspan stent for symptomatic M1 stenosis of middle cerebral artery. Eur J Radiol, 2011, 80(3):e356-360.
17. Lee JH, Yun JK, Kim DW, et al. Clinical and angiographic outcomes of wingspan stent placement for treatment of symptomatic intracranial stenosis:single center experience with 19 cases. J Cerebrovasc Endovasc Neurosurg, 2012, 14(3):157-163.
18. Zhao ZW, Deng JP, He SM, et al. Intracranial angioplasty with Gateway-Wingspan system for symptomatic atherosclerotic stenosis:preliminary results of 27 Chinese patients. Surgical neurology, 2009, 72(6):607-611.
19. Costalat V, Maldonado IL, Vendrell JF, et al. Endovascular treatment of symptomatic intracranial stenosis with the Wingspan stent system and Gateway PTA balloon:a multicenter series of 60 patients with acute and midterm results. J Neurosurg, 2011, 115(4):686-693.
20. Lanfranconi S, Bersano A, Branca V, et al. Stenting for the treatment of high-grade intracranial stenoses. J Neurol, 2010, 257(11):1899-1908.
21. Li J, Zhao ZW, Gao GD, et al. Wingspan stent for high-grade symptomatic vertebrobasilar artery atherosclerotic stenosis. Cardiovasc Intervent Radiol, 2012, 35(2):268-278.
22. Yue X, Yin Q, Xi G, et al. Comparison of BMSs with SES for symptomatic intracranial disease of the middle cerebral artery stenosis. Cardiovasc Intervent Radiol, 2011, 34(1):54-60.
23. Shin YS, Kim BM, Suh SH, et al. Wingspan stenting for intracranial atherosclerotic stenosis:clinical outcomes and risk factors for in-stent restenosis. Neurosurgery, 2013, 72(4):596-604.
24. Zhang L, Huang Q, Zhang Y, et al. A single-center study of Wingspan stents for symptomatic atherosclerotic stenosis of the middle cerebral artery. J Clin Neurosci, 2013, 20(3):362-366.
25. Henkes H, Miloslavski E, Lowens S, et al. Treatment of intracranial atherosclerotic stenoses with balloon dilatation and self-expanding stent deployment (WingSpan). Neuroradiology, 2005, 47(3):222-228.
26. Wolfe TJ, Fitzsimmons BF, Hussain SI, et al. Long term clinical and angiographic outcomes with the Wingspan stent for treatment of symptomatic 50-99% intracranial atherosclerosis:single center experience in 51 cases. J Neurointerv Surg, 2009, 1(1):40-43.
27. Tarlov N, Jahan R, Saver JL, et al. Treatment of high risk symptomatic intracranial atherosclerosis with balloon mounted coronary stents and Wingspan stents:single center experience over a 10 year period. J Neurointerv Surg, 2012, 4(1):34-39.
28. Samaniego EA, Tari-Capone F, Linfante I, et al. Wingspan experience in the treatment of symptomatic intracranial atherosclerotic disease after antithrombotic failure. J Neurointerv Surg, 2013, 5(4):302-305.
29. 张磊, 黄清海, 张永巍, 等. Wingspan支架治疗大脑中动脉症状性粥样硬化性狭窄. 中华神经外科杂志, 2012, 28(5):435-439.
30. 梁建峰, 何伟文, 伍健伟. Wingspan支架治疗后循环症状性颅内动脉狭窄的疗效. 中国老年学杂志, 2013, 33(12):2787-2788.
31. 罗望池, 李贵福, 李铁林, 等. Wingspan支架治疗症状性颅内动脉狭窄的疗效及随访. 介入放射学杂志, 2011, 20(7):513-517.
32. 马敏敏, 殷勤, 徐格林, 等. Wingspan支架治疗症状性颅内动脉狭窄术后再狭窄的相关因素分析. 中华医学杂志, 2011, 91(19):1303-1307.
33. 李天晓, 李钊硕, 王子亮, 等. Wingspan支架治疗症状性颅内动脉粥样硬化严重狭窄的临床研究. 中华放射学杂志, 2010, 44(9):969-974.
34. 许斌, 史怀璋, 徐善才, 等. Wingspan支架治疗症状性椎动脉颅内段和基底动脉狭窄的临床观察. 中华神经外科杂志, 2012, 28(12):1226-1229.
35. 杨志刚, 田春鸥, 张磊, 等. Wingspan支架治疗重度症状性颅内椎动脉粥样硬化性狭窄的疗效评价. 中国脑血管病杂志, 2013, 10(7):342-347, 364.
36. 李钊硕, 李天晓, 王子亮, 等. 单中心颅内动脉狭窄Wingspan支架成形术中及术后短期并发症分析. 中华放射学杂志, 2013, 47(2):166-171.
37. 高红华, 高连波. 支架成形术及药物治疗症状性大脑中动脉狭窄的随机对照研究. 介入放射学杂志, 2013, 22(2):89-92.
38. Holmstedt CA, Turan TN, Chimowitz MI. Atherosclerotic intracranial arterial stenosis:risk factors, diagnosis, and treatment. Lancet Neurol, 2013, 12(11):1106-1114.
39. Yang F, Liu L, Li M, et al. Pattern of cerebrovascular atherosclerotic stenosis in older Chinese patients with stroke. J Clin Neurosci, 2013, 20(7):979-983.
40. Pu Y, Liu L, Wang Y, et al. Geographic and sex difference in the distribution of intracranial atherosclerosis in China. Stroke, 2013, 44(8):2109-2114.
41. Gates L, Indes J. New treatment of iliac artery disease:focus on the Absolute Pro(R) Vascular Self-Expanding Stent System. Medical Devices (Auckland, N.Z.), 2013, 6:147-150.
42. Vajda Z, Schmid E, Guthe T, et al. The modified Bose method for the endovascular treatment of intracranial atherosclerotic arterial stenoses using the Enterprise stent. Neurosurgery, 2012, 70(1):91-101.
43. Chimowitz MI, Lynn MJ, Turan TN, et al. Design of the stenting and aggressive medical management for preventing recurrent stroke in intracranial stenosis trial. J Stroke Cerebrovasc Dis, 2011, 20(4):357-368.
44. Zaidat OO, Castonguay AC, Fitzsimmons BF, et al. Design of the Vitesse Intracranial Stent Study for Ischemic Therapy (VISSIT) trial in symptomatic intracranial stenosis. J Stroke Cerebrovasc Dis, 2013, 22(7):1131-1139.
45. A Feasibility Study of the Cordis Neurovascular Self Expanding Stent System in Intracranial Arteries. Available at:http://clinicaltrials.gov/ct2/show/NCT00349908.
46. An International Registry of the Wingspan^TM Stent System for the Treatment of Intracranial Atherosclerotic Stenosis (IRISS). Available at:http://clinicaltrials.gov/ct2/show/NCT00929383.
47. China Angioplasty & Stenting for Symptomatic Intracranial Severe Stenosis (CASSISS). Available at:http://clinicaltrials.gov/ct2/show/NCT01763320.
48. Clinical Registration Trial of Intracranial Stenting for Patients With Symptomatic Intracranial Artery Stenosis(CRTICAS). Available at:http://clinicaltrials.gov/ct2/show/NCT01994161.
49. Efficacy and Safety of Stent Implantation in Symptomatic Extra-and Intracranial Artery Stenosis (ESSCAS). Available at:http://clinicaltrials.gov/ct2/show/NCT00691314.
50. Registry Study of Stenting for Symptomatic Intracranial Artery Stenosis in China. Available at:http://clinicaltrials.gov/ct2/show/NCT01968122.
51. Stenting for Symptomatic Intracranial Artery Stenosis Registry in China. Available at:http://clinicaltrials.gov/ct2/show/NCT01830413.
52. Wingspan Stenting for Symptomatic Severe Stenosis of Intracranial Atherosclerosis Registry in China (WingspanSSIR). Available at:http://clinicaltrials.gov/ct2/show/NCT00685308.

Chinese Journal of Evidence-Based Medicine

Intracranial Angioplasty with Gateway-Wingspan System for Atherosclerotic Stenosis: A Meta-analysis of Single rate

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