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Initial experience with angioplasty of symptomatic M2 MCA atheromatous lesions
  1. Muhammad Shazam Hussain1,
  2. Esteban Cheng-Ching1,
  3. Mark Bain1,
  4. Alejandro M Spiotta1,
  5. Thinesh Sivapatham1,
  6. Ferdinand Hui1,
  7. Shaye I Moskowitz1,
  8. Rishi Gupta1,2
  1. 1Cerebrovascular Center, The Cleveland Clinic Foundation, Cleveland, Ohio, USA
  2. 2Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  1. Correspondence to Dr Rishi Gupta, Department of Neurology, Vanderbilt Stroke Center, A-0118 Medical Center North, Nashville, TN 37232-2551, USA; guptar{at}ccf.org

Abstract

Background and purpose Symptomatic intracranial atherosclerosis has been associated with a high rate of recurrent stroke. The safety of treatment of more distal atheromatous lesions with angioplasty has not been systematically reported.

Methods We retrospectively reviewed our institutional database for all patients treated with intracranial angioplasty and stenting from January 2008 to July 2009. A total of 108 patients were treated and five patients were treated with angioplasty for a symptomatic M2 middle cerebral artery stenosis with fluctuating neurological examinations. We report our experience with these patients.

Results All five patients underwent technically successful treatment with a reduction of the stenosis to <50%. There were no periprocedural complications and all patients had cessation of their clinical fluctuations. Two patients were found to have symptomatic restenosis with one patient suffering a disabling stroke at 5 months and the second patient a transient ischemic attack at 4 months who was subsequently successfully re-treated with angioplasty and stent placement.

Conclusions Angioplasty of M2 MCA lesions is technically feasible in our cohort of neurologically unstable patients, but the durability of this treatment will require more extensive study.

  • Artery
  • intervention
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Footnotes

  • Competing interests Rishi Gupta: Consultant/Scientific Advisory Board: Concentric Medical and CoAxia Inc. Alejandro Spiotta: Research Support Codman Corp.The other authors have no conflicts of interest to disclose.

  • Ethics approval This study was conducted with the approval of the Cleveland Clinic Foundation IRB.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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