Balloon-expandable stents for treatment of symptomatic middle cerebral artery stenosis: Clinical outcomes during long-term follow-up

Interv Neuroradiol. 2018 Dec;24(6):666-673. doi: 10.1177/1591019918786515. Epub 2018 Jul 10.

Abstract

Background: Insertion of a balloon-expandable stent (BES) in patients with symptomatic intracranial atherosclerosis is a treatment option for reperfusion therapy. In this study, we retrospectively reviewed clinical outcomes during long-term follow-up after insertion of balloon-expandable stents in patients with symptomatic middle cerebral artery (MCA) stenosis.

Methods: Institutional review board approval was obtained for retrospective review of patient data. Thirty-four patients (15 men, 19 women; median age, 67.5 years) with symptomatic MCA stenosis underwent balloon-expandable stent insertion between June 2008 and December 2010. Patient records were reviewed for angiographic findings and clinical outcomes during long-term follow-up.

Results: Of these patients, 22 presented with acute ischemic stroke with underlying MCA atherosclerosis and had good clinical outcomes (modified Rankin Scale score (mRS): 0-2) after reperfusion therapy. Indications for stenting for the remaining 12 patients were recurrent transient ischemic attacks (TIAs) refractory to medical therapy and MCA stenosis greater than 70%. During the poststenting follow-up period, which ranged from 61 to 108 months (median, 67.5 months), a TIA occurred in five patients. Of these five patients, one experienced a complete reocclusion of the MCA stent, and three had symptomatic restenosis. The remaining 29 patients did not experience any further ischemic events or restenosis during the follow-up period.

Conclusions: In our study, treatment with balloon-expandable stents in patients with symptomatic MCA stenosis resulted in low recurrence rates for both ischemic events and restenosis during long-term follow-up.

Keywords: Intracranial artery; stent; stroke.

MeSH terms

  • Aged
  • Angioplasty, Balloon
  • Brain Ischemia / etiology
  • Brain Ischemia / prevention & control
  • Endovascular Procedures / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Infarction, Middle Cerebral Artery / surgery*
  • Ischemic Attack, Transient / etiology
  • Ischemic Attack, Transient / prevention & control
  • Male
  • Middle Aged
  • Recurrence
  • Reperfusion
  • Retrospective Studies
  • Stents*
  • Stroke / etiology
  • Stroke / prevention & control
  • Treatment Outcome