Primary angioplasty for a subtype of symptomatic middle cerebral artery stenosis
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The purpose of this study was to assess the long-term efficacy of middle cerebral artery revascularisation by primary balloon angioplasty for the prevention of stroke in a certain subtype of patients.
A retrospective study was performed to evaluate 33 patients with symptomatic middle cerebral artery stenoses who underwent primary balloon angioplasty; the selection criteria were: greater than 70% stenosis measured by digital subtraction angiography, lesions equal to or shorter than 5 mm, lesions near or across a bifurcation, and lesions with very tortuous proximal vessels that increase the risk of stenting. All patients were available for follow-up ranging from 6 to 60 months. The technical success rate, periprocedural complications, and long-term outcome were retrospectively reviewed.
The mean stenosis degree was reduced from 87.12 ± 7.40 to 23.03 ± 9.84 after angioplasty. The periprocedural complication rate was 18.18% (six dissections without an ischemic event). Two patients had strokes in the territory of the angioplasty at 6 and 32 months after angioplasty, and the stroke-free survival at 5 years was 90.04% (mean survival time, 56.42 ± 2.43 months; 95% CI, 51.66–61.19 months).
These results suggest that this treatment is safe and could provide a durable clinical result at long-term follow-up in this subtype of patients, but the high rate of dissection remains a major technical drawback.
KeywordsAngioplasty Arteriosclerosis Middle cerebral artery
This study was sponsored by the Beijing Medical Development and Research Fund.
Conflict of interest statement
We declare that we have no conflict of interest.
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