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Elective stenting of symptomatic middle cerebral artery stenosis
C R Gomez1, V K Misra, M S Campbell
1The Comprehensive Stroke Center, Department of Neurology, The University of Alabama at Birmingham, USA.
Insights
Stenting offers a new treatment for middle cerebral artery stenosis, overcoming previous tracking challenges. This approach successfully treated a patient, demonstrating a viable option for complex intracranial atherosclerotic disease.
Area of Science:
- Neurology
- Interventional Cardiology
- Vascular Surgery
Background:
- Percutaneous balloon angioplasty is a treatment for intracranial atherosclerotic arterial stenosis.
- Arterial dissection is a risk of angioplasty, leading to closure, stroke, and restenosis.
- Intracranial stenting is feasible but challenging, especially for the middle cerebral artery due to the carotid siphon.
Observation:
- Successful treatment of symptomatic middle cerebral artery stenosis using a balloon-expandable flexible coronary stent.
- This method overcomes the difficulty of tracking stents across the carotid siphon.
Findings:
- The described technique allows for successful stenting of the middle cerebral artery.
- This represents a novel approach to treating complex intracranial stenosis.
Implications:
- This technique may expand treatment options for patients with middle cerebral artery stenosis.
- Further research could validate this approach for broader clinical application.
- Minimally invasive stenting could reduce risks associated with angioplasty for intracranial atherosclerotic disease.
Abstract:
Percutaneous balloon angioplasty has been found to be useful for the treatment of intracranial atherosclerotic arterial stenosis. Nonetheless, an ongoing risk of this procedure is arterial dissection, which increases the hazards of acute closure, stroke, and restenosis. Stenting of the intracranial vasculature recently has been shown to be feasible in a variety of circumstances. To our knowledge, however, stenting of the middle cerebral artery has not been possible until now primarily because of difficulty with tracking stents across the carotid siphon. We describe the successful treatment of a symptomatic middle cerebral artery stenosis achieved using a balloon-expandable flexible coronary stent.