RT Journal Article
SR Electronic
T1 Transluminal Angioplasty for Middle Cerebral Artery Stenosis in Patients with Acute Ischemic Stroke
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 553
OP 558
VO 20
IS 4
A1 Dae Chul Suh
A1 Kyu-Bo Sung
A1 Yong Soo Cho
A1 Choong Gon Choi
A1 Ho Kyu Lee
A1 Jae Hong Lee
A1 Jong Sung Kim
A1 Myoung Chong Lee
YR 1999
UL http://www.ajnr.org/content/20/4/553.abstract
AB BACKGROUND AND PURPOSE: Precutaneous transluminal angioplasty (PTA) is currently performed to treat supraaortic atherosclerotic lesions. Our purpose was to evaluate the safety and efficacy of PTA for middle cerebral artery (MCA) stenosis in patients with acute ischemic stroke.METHODS: We performed PTA with the use of a microballoon (2–2.5 mm in diameter and 10–13 mm in length) in 10 consecutive patients (mean age, 48 years) who met the following criteria: high-grade M1 stenosis (> 70%) and mild neurologic deficits (NIH stroke scale < 4) and/or recurrent transient ischemic attacks (TIAs) resistant to anticoagulation, or a large area of hypoperfusion in the MCA territory on brain perfusion SPECT scans. During follow-up, we administered antiplatelet agents and evaluated the status of restenosis by angiography (n = 2), brain perfusion SPECT (n = 4), and/or transcranial Doppler sonography (TCD) (n = 7).RESULTS: Stenotic arteries were successfully dilated in nine of 10 patients. Angioplasty failed in one patient because the balloon could not pass through the tortuous cavernous internal carotid artery. None of the patients experienced either peri- or postangioplasty complications. Residual stenosis was less than 50%, and clinical improvement, including elimination of TIAs in four patients who had suffered resistant TIAs, was observed in all patients; improvement of the cerebral perfusion was also noted in two patients with a large hypoperfusion area in the MCA territory. The average follow-up period was 11 months (range, 2 to 36 months). None experienced recurrent stroke during the follow-up period. TCD revealed decreased flow velocity of the MCA after angioplasty in seven patients.CONCLUSION: PTA of the proximal portion of the MCA seems to be a safe and effective therapeutic technique for the prevention of secondary ischemic stroke.