Abstract： Objective To assess the safety and long-term efficacy of the treatment for symptomatic atherosclerotic high-grade stenosis in middle cerebral artery with Gateway-Wingspan system.Methods A total of 69 cases treated with Wingspan stenting for symptomatic middle cerebral artery high-grade stenosis from July 2007 to June 201 1 in our hospital were reviewed.The baseline state of the patients,angiographic findings of pre-or post-procedure or during follow-up,peri-procedural complications,In-stent restenosis,ischemic events during the long-term follow-up were recorded.The cumulative probability of any stroke in the 30 days and ipsilateral strokes beyond 30 days was estimated using the Kaplan-Meier method.Results Sixty-seven of 69 patients were successfully stented(successful rate,97.1％).The mean degree of stenosis reduced from(80.1±8.0) ％ to(15.2±6.4) ％.All the information of 69 patients within 30 days was collected.Seven complications were recorded and the rate was 10.1％ (7/69).The complications included four hemorrhagic strokes and three ischemic strokes.Two of them were dead and one of them was disabled.Clinical follow-up beyond 30 days was achieved in 54 patients with follow up time of more than two years.The mean follow-up period was 39 months in 54 patients.In the period,four ischemic events(7.4％,4/54) happened,with 3(5.6％,3/54) ipsilateral recurrent strokes and 1(1.9％,1/54) ipsilateral transient ischemic attack.The cumulative probability of adverse events was 13.7％(95％CI 5.3％-22.1％) at 2 years and 15.9％ (95％CI 6.7％-25.1％) at 3 years.The median imaging follow-up was seven months(Range,6-69 months) in 36 patients.Six patients(16.7％) suffered from in-stent restenosis and 2 had symptomatic restenosis.Conclusions Stenting for symptomatic atherosclerotic high-grade stenosis in the middle cerebral artery with wingspan has prominent long-term preventative effect against ischemic strokes.But the relatively high rate of peri-procedural complications at the early stage may influence the curative effect.