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

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.

Republished: Endovascular recanalisation with drug coated balloon for chronic symptomatic middle cerebral artery total occlusion

2018 ◽  
Vol 10 (9) ◽  
pp. e24-e24 ◽  
Author(s):  
Jun Zhang ◽  
Xiao Zhang ◽  
Jin-Ping Zhang ◽  
Ju Han
Keyword(s):  
Middle Cerebral Artery ◽  
Medical Therapy ◽  
Cerebral Artery ◽  
De Novo ◽  
Total Occlusion ◽  
Good Outcome ◽  
Stent Restenosis ◽  
Drug Coated Balloon ◽  
In Stent Restenosis

The optimal treatment for patients with chronic symptomatic middle cerebral artery (MCA) total occlusion is not well established. In addition to medical therapy, vessel recanalisation with stenting has shown much promise, especially for patients with recurrent ischemic symptoms. Nevertheless, the incidence of symptomatic in-stent restenosis (ISR) is high, and is associated with an unfavorable prognosis. Drug coated balloons (DCBs) have been proven to be effective in treating and preventing ISR. However, the feasibility of DCBs for de novo intracranial atherothrombotic stenosis has not been previously described, especially for total occlusion lesions. Here we reported a patient with chronic left MCA total occlusion successfully treated with DCBs, with a good outcome at the 1 year follow-up. More studies are warranted to further compare the efficacy of DCBs and stentings for intracranial revascularisation.

Adjuvant use of abciximab for balloon angioplasty of symptomatic middle cerebral artery stenosis

2005 ◽  
Vol 46 (5) ◽  
pp. 534-538 ◽  
Author(s):  
D. H. Lee ◽  
K. D. Jo
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Balloon Angioplasty ◽  
Artery Stenosis ◽  
Main Trunk ◽  
Acute Thrombosis ◽  
Proximal Middle Cerebral Artery ◽  
Symptomatic Stenosis ◽  
Middle Cerebral Artery Stenosis

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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