Primary angioplasty for a subtype of symptomatic middle cerebral artery stenosis

Neuroradiology. 2011 Sep;53(9):651-7. doi: 10.1007/s00234-010-0778-2. Epub 2010 Oct 8.


Introduction: The purpose of this study was to assess the long-term efficacy of middle cerebral artery revascularisation by primary balloon angioplasty for the prevention of stroke in a certain subtype of patients.

Method: A retrospective study was performed to evaluate 33 patients with symptomatic middle cerebral artery stenoses who underwent primary balloon angioplasty; the selection criteria were: greater than 70% stenosis measured by digital subtraction angiography, lesions equal to or shorter than 5 mm, lesions near or across a bifurcation, and lesions with very tortuous proximal vessels that increase the risk of stenting. All patients were available for follow-up ranging from 6 to 60 months. The technical success rate, periprocedural complications, and long-term outcome were retrospectively reviewed.

Result: The mean stenosis degree was reduced from 87.12 ± 7.40 to 23.03 ± 9.84 after angioplasty. The periprocedural complication rate was 18.18% (six dissections without an ischemic event). Two patients had strokes in the territory of the angioplasty at 6 and 32 months after angioplasty, and the stroke-free survival at 5 years was 90.04% (mean survival time, 56.42 ± 2.43 months; 95% CI, 51.66-61.19 months).

Conclusion: These results suggest that this treatment is safe and could provide a durable clinical result at long-term follow-up in this subtype of patients, but the high rate of dissection remains a major technical drawback.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon* / methods
  • Cerebral Angiography
  • Constriction, Pathologic / diagnostic imaging
  • Constriction, Pathologic / pathology*
  • Constriction, Pathologic / therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Infarction, Middle Cerebral Artery / diagnostic imaging
  • Infarction, Middle Cerebral Artery / pathology
  • Infarction, Middle Cerebral Artery / prevention & control*
  • Male
  • Middle Aged
  • Middle Cerebral Artery / diagnostic imaging
  • Middle Cerebral Artery / pathology*
  • Retrospective Studies
  • Treatment Outcome