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Percutaneous transluminal angioplasty for total occlusion of middle cerebral arteries
Insights
Percutaneous transluminal cerebral angioplasty (PTCBA) can safely open recent total occlusions of the middle cerebral artery in the chronic stroke stage. Older occlusions proved more challenging to open with this interventional radiology technique.
Area of Science:
- Neurology
- Interventional Radiology
- Vascular Surgery
Background:
- Intracranial artery total occlusions pose challenges for stroke treatment.
- The safety and efficacy of angioplasty for chronic intracranial occlusions remain debated.
- Middle cerebral artery occlusions are a common cause of ischemic stroke.
Purpose of the Study:
- To evaluate the safety and feasibility of percutaneous transluminal cerebral angioplasty (PTCBA) for total occlusions of the middle cerebral artery in the chronic stroke stage.
- To determine the success rate of PTCBA based on the age of the occlusion.
Main Methods:
- Six patients with chronic total occlusions of the middle cerebral artery (average 10 weeks post-stroke) underwent PTCBA.
- Occlusions were categorized based on age (less than or greater than 3 months).
- Procedure safety and success in opening the occlusions were assessed.
Main Results:
- PTCBA successfully opened four out of six total occlusions.
- All successfully opened occlusions were less than 3 months old.
- Two occlusions older than 3 months could not be opened.
- No complications were reported during or after the procedures.
Conclusions:
- PTCBA is a safe interventional radiology procedure for treating recent total occlusions of the middle cerebral artery in the chronic stroke phase.
- The recanalization success of PTCBA for middle cerebral artery total occlusions appears dependent on the age of the occlusion, with younger occlusions being more amenable to treatment.
Abstract:
Although it is controversial whether total occlusions of intracranial arteries can safely be opened by angioplasty, we treated six patients with total occlusions of the middle cerebral artery by percutaneous transluminal cerebral angioplasty (PTCBA) in the chronic stage after a stroke, on average 10 weeks. We successfully opened four total occlusions less than 3 months old, while two total occlusions more than 3 months old could not be opened. No complications occurred. Even in the chronic stage, PTCBA for total occlusion of intracranial arteries can be done safely.