Registries

Large vessel intracranial atherosclerosis is increasingly recognized as a major cause of ischemic stroke. In ethnically mixed populations, it may account for 8% of incident ischemic stroke, with a preponderance among minorities.¹ With the failure of extracranial–intracranial bypass surgery² and the emergence of neuroendovascular techniques, aggressive approaches to these lesions have been reported for more than 25 years.³ To date, most experience has been using devices and techniques borrowed from coronary interventions. These devices have technical limitations when used in the cerebral circulation. The Wingspan stent is a self-expanding stent developed specifically as a device for intracranial use. Initial reports of its use have been modestly encouraging.^4-6

In this issue of Neurology®, Zaidat et al. ⁷ report experience with the Wingspan stent in 129 patients with severe, recently symptomatic intracranial arterial stenosis at 16 medical centers in the United States. The patients were selected based on angiographic and clinical criteria that placed them at especially high risk for early recurrent stroke. Using a registry mechanism, data were prospectively collected …