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WOVEN Trial: Wingspan One-year Vascular Events

In the WEAVE on-label Wingspan cohort followed to 1 year, what was the cumulative stroke or death rate? (Single-arm follow-up of 129 of the 152 patients, no concurrent control. The dashed line is a historical medical-therapy rate shown for context only.)

Alexander et al. (J Neurointerv Surg 2021;13(4):307–310) · doi:10.1136/neurintsurg-2020-016208 · 129 patients

Population

Included

  • Enrolled in the WEAVE on-label Wingspan cohort and available for 1-year follow-up (129 of 152 patients, 12 of 24 sites)
  • Symptomatic intracranial atherosclerotic stenosis 70 to 99%
  • At least 2 strokes or TIAs in the territory of the stenotic vessel despite optimal medical therapy
  • Age 22 to 80 years
  • Modified Rankin Score 3 or less at enrollment
  • More than 8 days since most recent qualifying ischemic event
  • Target vessel diameter 2.0 to 4.5 mm; lesion length 9 mm or less

Excluded

  • Off-label use of the Wingspan stent system
  • Acute stroke or TIA within 8 days of enrollment
  • Allergy to aspirin, clopidogrel, or contrast media
  • Untreated coagulopathy or platelet count below 100,000
  • Pregnancy or breastfeeding
  • Concurrent participation in another investigational device trial

Primary Outcome

Stroke or death at 1 year (includes 4 periprocedural events)

11/129 patients (8.5%)95% CI 4.3–14.8%(Clopper-Pearson exact (computed))Single-arm, no control

Historical Context

Observational context only

Historical rates come from different patient populations (initial-presentation ICAS, not refractory on-label failures), study designs, and eras. Direct comparison to WOVEN is exploratory. These data provide context only, not a randomized control arm.

Trial / RegistryYearNDesignEvent rate
SAMMPRIS stent arm2011224Randomized vs medical therapy, off-label use; 1-year rate
20%
SAMMPRIS medical arm2011227Randomized aggressive medical management; 1-year rate
12.2%
WOVEN TrialThis trial2021129Single-arm 1-year follow-up of the WEAVE on-label cohort
8.5%

Event rate = periprocedural stroke or death. Rates are not directly comparable across studies due to differences in patient selection, operator experience, study era, and outcome assessment windows.

Study Arms

Agent
Gateway PTA balloon catheter for angioplasty followed by the Wingspan self-expanding nitinol stent (Stryker Neurovascular)
Route
Endovascular (intracranial angioplasty and stenting)
Frequency
Single index procedure in WEAVE; WOVEN adds clinical follow-up to 1 year
Duration
One-time procedure with follow-up to 1 year
Co-interventions
Dual antiplatelet therapy and intensive medical management as in WEAVE: aspirin plus clopidogrel around the procedure, continued antiplatelet therapy, statin, and blood-pressure control afterward.

Single-arm follow-up of the WEAVE on-label cohort; no randomized control and no pre-specified 1-year threshold. 129 of the 152 WEAVE on-label patients (about 85%) were followed at 12 of the 24 original sites. During follow-up there were 7 strokes (6 minor, 1 major) and no deaths beyond the periprocedural period; adding the 4 WEAVE periprocedural events gives 11 strokes or deaths of 129 (8.5%) at 1 year. Source: Alexander J Neurointerv Surg 2021;13(4):307–310.

Trial Design

Type

  • Single-arm 1-year follow-up of the WEAVE on-label Wingspan cohort
  • No control arm; descriptive safety follow-up
  • 129 of 152 WEAVE on-label patients followed at 12 of 24 original sites

Timeline

One-year follow-up of the WEAVE cohort (enrolled 2014 to 2017)

N

129

Enrollment

129 of the 152 WEAVE on-label patients, followed at 12 of the 24 original US centers. One-year follow-up of the WEAVE post-market surveillance cohort. Single-arm, no control. Published J Neurointerv Surg 2021.

ClinicalTrials.gov

NCT02034058

Bedside Pearl

WOVEN followed the WEAVE on-label Wingspan cohort to 1 year. Of 129 patients followed (of the original 152), there were 11 strokes or deaths (8.5%) at 1 year, including the 4 WEAVE periprocedural events: 7 new strokes during follow-up (6 minor, 1 major) and no deaths beyond the periprocedural period. WOVEN has no control arm and no pre-specified 1-year threshold, so it describes durability of the WEAVE safety signal but does not establish efficacy versus medical therapy. The SAMMPRIS medical-arm 12.2% 1-year rate is a historical reference from a different population, not a randomized comparison. Aggressive medical therapy remains first-line for symptomatic intracranial atherosclerotic disease; on-label Wingspan stenting stays a salvage option for highly selected refractory patients.

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