Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
J Neurointerv Surg. 2010 Sep;2(3):192-4. doi: 10.1136/jnis.2009.001818. Epub 2010 Jun 4.
Symptomatic intracranial atherosclerosis has been associated with a high rate of recurrent stroke. The safety of treatment of more distal atheromatous lesions with angioplasty has not been systematically reported.
We retrospectively reviewed our institutional database for all patients treated with intracranial angioplasty and stenting from January 2008 to July 2009. A total of 108 patients were treated and five patients were treated with angioplasty for a symptomatic M2 middle cerebral artery stenosis with fluctuating neurological examinations. We report our experience with these patients.
All five patients underwent technically successful treatment with a reduction of the stenosis to <50%. There were no periprocedural complications and all patients had cessation of their clinical fluctuations. Two patients were found to have symptomatic restenosis with one patient suffering a disabling stroke at 5 months and the second patient a transient ischemic attack at 4 months who was subsequently successfully re-treated with angioplasty and stent placement.
Angioplasty of M2 MCA lesions is technically feasible in our cohort of neurologically unstable patients, but the durability of this treatment will require more extensive study.
症状性颅内动脉粥样硬化与较高的复发卒中率相关。血管成形术治疗更远处动脉粥样硬化病变的安全性尚未得到系统报道。
我们回顾性分析了 2008 年 1 月至 2009 年 7 月期间接受颅内血管成形术和支架置入术的所有患者的机构数据库。共治疗了 108 例患者，5 例患者因症状性 M2 大脑中动脉狭窄伴波动性神经检查而行血管成形术治疗。我们报告了这些患者的经验。
所有 5 例患者均成功进行了技术上的治疗，狭窄程度降至<50%。无围手术期并发症，所有患者的临床波动均停止。2 例患者出现症状性再狭窄，1 例患者在 5 个月时发生致残性卒中，第 2 例患者在 4 个月时发生短暂性脑缺血发作，随后成功接受了血管成形术和支架置入术治疗。
在我们神经不稳定患者的队列中，M2 MCA 病变的血管成形术在技术上是可行的，但这种治疗的耐久性需要更广泛的研究。
