INTRODUCTION: The purpose of this study was to assess the long-term efficacy of middle cerebral artery revascularisation by primary balloon angioplasty for the prevention of stroke in a certain subtype of patients. METHOD: A retrospective study was performed to evaluate 33 patients with symptomatic middle cerebral artery stenoses who underwent primary balloon angioplasty; the selection criteria were: greater than 70% stenosis measured by digital subtraction angiography, lesions equal to or shorter than 5 mm, lesions near or across a bifurcation, and lesions with very tortuous proximal vessels that increase the risk of stenting. All patients were available for follow-up ranging from 6 to 60 months. The technical success rate, periprocedural complications, and long-term outcome were retrospectively reviewed. RESULT: The mean stenosis degree was reduced from 87.12 ± 7.40 to 23.03 ± 9.84 after angioplasty. The periprocedural complication rate was 18.18% (six dissections without an ischemic event). Two patients had strokes in the territory of the angioplasty at 6 and 32 months after angioplasty, and the stroke-free survival at 5 years was 90.04% (mean survival time, 56.42 ± 2.43 months; 95% CI, 51.66-61.19 months). CONCLUSION: These results suggest that this treatment is safe and could provide a durable clinical result at long-term follow-up in this subtype of patients, but the high rate of dissection remains a major technical drawback.
INTRODUCTION: The purpose of this study was to assess the long-term efficacy of middle cerebral artery revascularisation by primary balloon angioplasty for the prevention of stroke in a certain subtype of patients. METHOD: A retrospective study was performed to evaluate 33 patients with symptomatic middle cerebral artery stenoses who underwent primary balloon angioplasty; the selection criteria were: greater than 70% stenosis measured by digital subtraction angiography, lesions equal to or shorter than 5 mm, lesions near or across a bifurcation, and lesions with very tortuous proximal vessels that increase the risk of stenting. All patients were available for follow-up ranging from 6 to 60 months. The technical success rate, periprocedural complications, and long-term outcome were retrospectively reviewed. RESULT: The mean stenosis degree was reduced from 87.12 ± 7.40 to 23.03 ± 9.84 after angioplasty. The periprocedural complication rate was 18.18% (six dissections without an ischemic event). Two patients had strokes in the territory of the angioplasty at 6 and 32 months after angioplasty, and the stroke-free survival at 5 years was 90.04% (mean survival time, 56.42 ± 2.43 months; 95% CI, 51.66-61.19 months). CONCLUSION: These results suggest that this treatment is safe and could provide a durable clinical result at long-term follow-up in this subtype of patients, but the high rate of dissection remains a major technical drawback.
Authors: Rishi Gupta; Firas Al-Ali; Ajith J Thomas; Michael B Horowitz; Thomas Barrow; Nirav A Vora; Ken Uchino; Maxim D Hammer; Lawerence R Wechsler; Tudor G Jovin Journal: Stroke Date: 2006-09-07 Impact factor: 7.914
Authors: Adnan I Qureshi; Haitham M Hussein; Ahmed El-Gengaihy; Mohamed Abdelmoula; M Fareed K Suri Journal: Neurosurgery Date: 2008-05 Impact factor: 4.654
Authors: Thomas W Leung; Simon C H Yu; Wynnie W M Lam; Anne Y Y Chan; Alexander Y L Lau; Lawrence K S Wong Journal: Stroke Date: 2009-01-29 Impact factor: 7.914
Authors: Michael P Marks; Joan C Wojak; Firas Al-Ali; Mahesh Jayaraman; Mary L Marcellus; John J Connors; Huy M Do Journal: Stroke Date: 2006-02-23 Impact factor: 7.914