Early experiences of elective stenting for symptomatic stenosis of the M1 segment of the middle cerebral artery: reports of three cases and review of the literature.

The role of stenting in the treatment of patients with middle cerebral artery stenosis is not defined because of the high risk and difficulty in tracking. However, recent improvements in the technology, in particular of small, flexible stents and of small, flexible stents with accumulative stenting experience in occlusive intracranial disease endovascular treatment of this disease is now possible. We treated three patients with a symptomatic stenosis of the M1 segment of the middle cerebral artery despite combination anticoagulation therapy. All patients were successfully treated with a balloon-expandable S660 coronary stent. No procedure-related complications occurred and all patients were discharged and remained neurologically stable during the follow-up period (2-12 months). We propose stenting as one of the treatment modalities in patients with symptomatic stenosis of the M1 segment of the middle cerebral artery in selected cases. However, further studies on this new procedure should be done to determine its effect on long-term stroke prevention and to compare its safety with other treatment options.