Zhu Peng-Cheng, Shu Ling-Feng, Dai Qing-Hai, Tan Hong-Tu, Wang Jia-Bin, Wu Tao
Department of Intervention, Encephalopathy Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450000, Henan Province, China.
The First Clinical Medical College, Henan University of Traditional Chinese Medicine, Zhengzhou 450046, Henan Province, China.
World J Clin Cases. 2024 Jul 6;12(19):3956-3960. doi: 10.12998/wjcc.v12.i19.3956.
Intracranial arterial narrowing is a significant factor leading to brief episodes of reduced blood flow to the brain, known as transient ischemic attacks, or full-blown strokes. While atherosclerosis is commonly associated with intracranial arterial narrowing, it is frequently of a non-atherosclerotic nature in younger patients.
Here, we present the case of a young stroke patient with narrowing of the middle cerebral artery (MCA), characterized as non-atherosclerotic lesions, who experienced an ischemic stroke despite receiving standard drug therapy. The patient underwent digital subtraction angiography (DSA) to assess the entire network of blood vessels in the brain, revealing significant narrowing (approximately 80%) in the M1 segment of the right MCA. Subsequently, the patient underwent Drug-Coated Balloon Angioplasty to treat the stenosis in the right MCA's M1 segment. Follow-up DSA confirmed the resolution of stenosis in this segment. Although the remaining branches showed satisfactory blood flow, the vessel wall exhibited irregularities. A review of DSA conducted six months later showed no evident stenosis in the right MCA, with a smooth vessel wall.
The use of drug-coated balloon angioplasty demonstrated favorable outcomes in repairing and reshaping the blood vessel wall in young patients. Therefore, it may be considered a promising treatment option for similar cases.
颅内动脉狭窄是导致脑部血流短暂减少（即短暂性脑缺血发作）或全面性中风的重要因素。虽然动脉粥样硬化通常与颅内动脉狭窄有关，但在年轻患者中，它往往具有非动脉粥样硬化的性质。
在此，我们报告一例年轻的中风患者，其大脑中动脉（MCA）狭窄，表现为非动脉粥样硬化性病变，尽管接受了标准药物治疗仍发生了缺血性中风。患者接受了数字减影血管造影（DSA）以评估脑部血管的整个网络，结果显示右侧大脑中动脉M1段存在明显狭窄（约80%）。随后，患者接受了药物涂层球囊血管成形术来治疗右侧大脑中动脉M1段的狭窄。随访DSA证实该段狭窄已消除。尽管其余分支显示血流良好，但血管壁仍有不规则之处。六个月后进行的DSA复查显示右侧大脑中动脉无明显狭窄，血管壁光滑。
药物涂层球囊血管成形术在修复和重塑年轻患者血管壁方面显示出良好的效果。因此，对于类似病例，它可能被认为是一种有前景的治疗选择。
