Cognitive Decline in Asymptomatic Middle Cerebral Artery Stenosis Patients with Moderate and Poor Collaterals: A 2-Year Follow-Up Study

Purpose: To evaluate the safety of adjuvant intravenous use of abciximab in balloon angioplasty for symptomatic middle cerebral artery stenosis. Material and Methods: Seven patients with symptomatic stenosis at the main trunk ( n = 5), or proximal post-trifurcation portion ( n = 2) of the middle cerebral artery, were enrolled in the study. A bolus dose of abciximab (0.15 mg/kg) was given intravenously immediately before the procedure. The immediate morphologic results as well as the presence of hyperacute thrombosis or hemorrhage after angioplasty were evaluated. Clinical evaluation was performed 1 day and 1 month following angioplasty. Oral antiplatelets were administered during the follow-up period. Follow-up angiography was performed after 7 to 14 (mean 10.4) months. Stenosis of a vessel greater than 50% was considered as restenosis. Results: The procedure was technically successful in all patients. Immediate residual stenosis was insignificant in 4 and mild (less than 50%) in 3 patients. There was no evidence of intimal dissection. Mild gum bleeding was noted in two patients. All study patients were clinically stable at follow-up without newly developed neurological abnormality even though there was one case of occlusion and one case of restenosis on follow-up angiography. Angiographic patency rate was 71%. Conclusion: In performing proximal middle cerebral artery balloon angioplasty, abciximab may be safely used to prevent acute thrombosis. The mid-term patency of the vessels was also acceptable.

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Percutaneous Transluminal Angioplasty for Symptomatic Middle Cerebral Artery Stenosis: Long-Term Follow-Up

Cerebrovascular Diseases ◽

10.1159/000067135 ◽

2003 ◽

Vol 15 (1-2) ◽

pp. 90-97 ◽

Cited By ~ 39

Author(s):

Ju H. Lee ◽

Sun U. Kwon ◽

Jae H. Lee ◽

Dae C. Suh ◽

Jong S. Kim

Keyword(s):

Middle Cerebral Artery ◽

Cerebral Artery ◽

Percutaneous Transluminal Angioplasty ◽

Transluminal Angioplasty ◽

Artery Stenosis ◽

Long Term Follow Up ◽

Percutaneous Transluminal ◽

Middle Cerebral Artery Stenosis

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A Comparison of Safety and Effectiveness Between Wingspan and Neuroform Stents in Patients With Middle Cerebral Artery Stenosis

Frontiers in Neurology ◽

10.3389/fneur.2021.527541 ◽

2021 ◽

Vol 12 ◽

Author(s):

Kai Zhou ◽

Yuan Cao ◽

Xiao-Hui He ◽

Zhong-Ming Qiu ◽

Shuai Liu ◽

...

Keyword(s):

Propensity Score ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Transluminal Angioplasty ◽

Artery Stenosis ◽

Stent Restenosis ◽

Neuroform Stent ◽

Middle Cerebral Artery Stenosis ◽

In Stent Restenosis

Background: Percutaneous transluminal angioplasty and stenting with the Wingspan stent has proven safe and effective in patients with middle cerebral artery stenosis (MCAS), but the off-label use of the Neuroform stent might be an alternative treatment. This study aimed to compare the safety and effectiveness of the above two intracranial stents in patients with MCAS.Methods: We retrospectively analyzed consecutive patients with symptomatic MCAS who had been treated with the Neuroform EZ or the Wingspan stent. A propensity score was generated to control for differences in baseline characteristics. The endpoints were the rate of peri-procedural complications within 30 days after stenting, the in-stent restenosis rate, and any target-vessel-related stroke or deaths during follow-up.Results: After matching for propensity score, the peri-procedural complication rate in the Wingspan group was 7.4% compared with 5.6% in the Neuroform group (p = 1.00), while the follow-up in-stent restenosis rates were 23.3 vs. 14.3%, respectively (p = 0.41). In the restenosis group, the patients tended to be younger (p < 0.01) and the degree of artery stenosis before stenting was higher (p < 0.01).Conclusion: This study indicated that in patients with symptomatic MCAS, Neuroform EZ stents are an alternative to Wingspan. Moreover, younger age and higher degree of artery stenosis before stenting might be a risk factor of in-stent restenosis.

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