ABSTRACT
Objective To explore the efficacy and safety of endovascular therapy in the treatment of symptomatic M1 stenosis of middle cerebral artery as well as the causes of perioperative complications.Methods Two hundred fifty-six patients with symptomatic M1 stenosis of middle cerebral artery (＞90％) confirmed by TCD,cerebral CT angiography and DSA was treated by endovascular intervention.The success rate,the changes of stenosis,longterm vascular patency rate,in-stent restenosis rate were analyzed.Results endovascular stent was successfully placed in 251 patients with the M1 part of symptomatic middle cerebral artery stenosis and the successful rate was 98.05％.Fifteen patients had complications (5.86％) which caused neurology deficits and deaths.The degree of vascular stenosis was significantly reduced after stenosis (Before vs After:92.26％±2.11％ vs 15.40％±2.60％).The mean mRS and NIHSS scores was decreased significantly.The average follow-up duration was (21.70±0.80) months,249 patients underwent a second DSA and the mean stenosis was (21.70％±0.80％).Twenty-three patients developed instent restenosis (ISR) and ISR rate was 9.24％.Recurrence ischemic stroke and transient ischemic attacks occurred in 5 patients and recurrence rate was 2.01％.Conclusion Endovascular therapy of symptomatic M1 stenosis of middle cerebral artery is safety and efficacy with low complications.The follow-up results reveal good patency rate and excellent prevention of anterior circulation ischemia.
ABSTRACT
Objective To explore the efficacy,safety and short-term effects of endovascular therapy in the treatment of the symptomatic high-grade basilar artery stenosis.Methods Two hundred thirteen patients with the symptomatic high-grade basilar artery stenosis (＞90％) confirmed by MRA,CTA or DSA was treated by endovascular intervention,the changes of clinical symptoms,the success rate and short-term follow-up results was analyzed.Results Endovascular stent was successfully placed in 209 patients with symptomatic high-grade basilar artery stenosis and the success rate was 98.12％.The degree of vascular stenosis was significantly reduced after stenosis (Before vs After:93.70％±2.51％ vs 11.60％±3.90％).Eight patients had complications (3.76％) including 7 cases of ischemic stroke and 1 case of subarachnoid hemorrhage.The average follow-up duration was 18.70±3.80 months.Two hundred two patients underwent a second DSA and the mean vascular stenosis was (13.80％±4.20％).Five patients developed in-stent restenosis (ISR),of which one was symptomatic.Conclusion Endovascular therapy of the symptomatic high-grade basilar artery stenosis is safety and efficacy.The 1.5 years follow-up results reveal good patency rate and excellent prevention of posterior circulation ischemia.