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Initial experience with angioplasty of symptomatic M2 MCA atheromatous lesions

Muhammad Shazam Hussain1, Esteban Cheng-Ching, Mark Bain

  • 1Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Journal of Neurointerventional Surgery
|October 13, 2011
PubMed
Abstract

Insights

Angioplasty for symptomatic M2 middle cerebral artery stenosis is feasible, but long-term durability requires further investigation. This treatment showed initial success in stabilizing neurological symptoms.

Area of Science:

  • Neurology
  • Interventional Neuroradiology
  • Vascular Neurology

Background:

  • Symptomatic intracranial atherosclerosis carries a high risk of recurrent stroke.
  • Treatment options for distal atheromatous lesions, such as angioplasty, lack systematic safety data.

Purpose of the Study:

  • To evaluate the safety and efficacy of angioplasty for symptomatic M2 middle cerebral artery stenosis.
  • To report the initial experience with treating neurologically unstable patients with this condition.

Main Methods:

  • Retrospective review of patients undergoing intracranial angioplasty and stenting from January 2008 to July 2009.
  • Focus on five patients treated for symptomatic M2 middle cerebral artery stenosis with fluctuating neurological examinations.

Main Results:

  • Technically successful angioplasty achieved stenosis reduction to <50% in all five patients.
  • No periprocedural complications were observed, and neurological fluctuations ceased post-treatment.
  • Two patients developed symptomatic restenosis, one experiencing a disabling stroke and the other a transient ischemic attack, requiring re-treatment.

Conclusions:

  • Angioplasty for M2 middle cerebral artery lesions is technically feasible in neurologically unstable patients.
  • The long-term durability of this endovascular treatment necessitates further, more extensive study.

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