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FIG 1. A 71-year-old woman with recurrent TIA symptoms.
A, Anteroposterior oblique left ICA angiogram shows severe stenosis (about 70%, arrow) in the M1 portion of the left MCA.
B, Balloon-mounted coronary stent (arrow) is positioned at the lesion, and the microwire is anchored in the distal branch of the MCA.
C, At 4 atm, the balloon is initially expanded at the distal and proximal ends of the stent (dumbbell phenomenon, arrows).
D, At 6 atm, the balloon expands in the center section containing the stent (arrow).
E, When no gap is present between the distal end of the stent and the parent artery on angiography, the balloon tip (long arrow) is pulled back into the distal end of the stent (short arrow) to prevent dissection and rupture of the parent artery. Balloon inflation is restarted.
F, Immediate postprocedural anteroposterior left ICA angiogram shows excellent recanalization (arrow) of the diseased segment, with preservation of the lateral lenticulostriate arteries.
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