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Plaque features of the middle cerebral artery are associated with periprocedural complications of intracranial angioplasty and stenting

  • Interventional Neuroradiology
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Abstract

Purpose

The identification of plaque features in the middle cerebral artery (MCA) may help minimize periprocedural complications and select patients suitable for percutaneous transluminal angioplasty and stenting (PTAS). However, relevant research is lacking.

Methods

We retrospectively included patients with symptomatic MCA stenosis who received PTAS. All patients underwent intracranial vessel wall MRI (VWMRI) before surgery. Periprocedural complications (PC) included ischemic and hemorrhagic stroke within 30 days. Stenosis location, MCA shape, plaque eccentricity and distribution, plaque thickness and length, and enhancement ratio were compared between patients with and without PC.

Results

Sixty-six patients were included in the study, of which 12.1% (8/66) had PC. Of the eight patients with PC, seven (87.5%) had superior wall plaques. In the non-PC group (n = 58), nine (17%) patients had superior wall plaques. Compared with patients without PC, those with PC had more frequent superior wall plaques (17% vs 87.5%, p < 0.001) and s-shaped MCAs (19% vs 50%, p = 0.071), different stenosis locations (p = 0.012), thicker plaques (1.58 [1.35, 2.00] vs 1.98 [1.73, 2.43], p = 0.038), and less frequent inferior wall plaques (79.2% vs 12.5%, p < 0.001). Multivariate analysis showed that only the presence of superior wall plaques (OR = 41.54 [2.31, 747.54]) was independently associated with PC.

Conclusion

MCA plaque features were highly correlated with PC in patients with symptomatic MCA stenosis who underwent PTAS.

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Data availability

The data underlying this article will be shared on reasonable request to the corresponding author.

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Authors and Affiliations

  1. Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, 16766 Jingshi Road, Jinan, 250014, Shandong, China

    Yao Meng, Miyengi Cosmas Magigi, Yun Song, Wei Zhao, Meimei Zheng, Lili Sun, Hao Yin, Wei Wang, Jun Zhang & Ju Han

Authors
  1. Yao Meng
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  2. Miyengi Cosmas Magigi
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  3. Yun Song
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  4. Wei Zhao
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  5. Meimei Zheng
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  6. Lili Sun
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  7. Hao Yin
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  8. Wei Wang
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  9. Jun Zhang
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  10. Ju Han
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Contributions

Conceptualization: Ju Han, Yao Meng; methodology: Yao Meng, Jun Zhang, Wei Zhao, Wei Wang; formal analysis and investigation: Meimei Zheng, Lili Sun, Hao Yin; writing — original draft preparation: Yao Meng; writing — review and editing: Miyengi Cosmas Magigi, Yun Song, Ju Han.

Corresponding author

Correspondence to Ju Han.

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Conflict of interest

The authors declare no competing interests.

Ethical approval

This study was approved by the Ethics Committee of the Institutional Review Board.

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Formal consent was not required due to the retrospective and observational nature of the study.

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Clinical significance

This study emphasizes the importance of baseline assessment of MCA plaque features, adding value in reducing periprocedural complications.

Supplementary Information

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Supplementary file1 (DOCX 45 KB)

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Meng, Y., Magigi, M.C., Song, Y. et al. Plaque features of the middle cerebral artery are associated with periprocedural complications of intracranial angioplasty and stenting. Neuroradiology 66, 109–116 (2024). https://doi.org/10.1007/s00234-023-03244-4

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  • DOI: https://doi.org/10.1007/s00234-023-03244-4

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