CT angiographic appearance of in-stent restenosis of intracranial arteries treated with the Wingspan stent

Four patients underwent angioplasty and stenting of medically refractory symptomatic intracranial atherosclerosis with the new Wingspan stent system. In all 4 patients, CT angiography (CTA) showed an abnormality within the stented segment that was suggestive of nonocclusive in-stent thrombus. However, subsequent conventional angiography findings were typical for in-stent restenosis. The CTA imaging features of in-stent restenosis are important to recognize, and the misinterpretation of in-stent restenosis as in-stent thrombus may result in inappropriate management.