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Objective To analyze the efficacy and hemodynamic changes in patients with complex symptomatic middle cerebral artery stenosis after Solitaire AB stent implantation.Methods From June 2013 to June 2016,7 consecutive patients with complex symptomatic middle cerebral artery stenosis treated with Solitaire stents at the Department of Neurology,the Third People's Hospital of Hubei Province were enrolled retrospectively.The stenosis rate ≥70% was confirmed by digital subtraction angiography (DSA).Of the 7 patients,5 were male and 2 were female,with an average age of 70±8 years.The general data of the patients were documented,including clinical symptoms,modified Rankin scale(mRS)score,stenosis degree,vascular pathways LMA classification and Mori typing for stenosis,and postoperative residual stenosis or restenosis.The hemodynamic parameters at day 1,7,and 3 months before and after procedure were compared.Results All patients were successfully implanted with the Solitaire AB stents.(1) Of the 7 patients,the Mori type A of stenosis lesions was in 4 cases,B in 2 cases,and C in 1 case.The LMA typing of vascular approaches were Type Ⅲ in 3 cases,type Ⅱ in 4 cases.The preoperative stenosis rate was 80±7%,the residual stenosis rate was 24±13%,and there were no operation-related complications.No ischemic events occurred during the follow-up period.(2) Before stent implantation and at 1 d,7 d,and 3 months after procedure,the peak systolic velocity (PSV) were 297±41,144±34,145±27,and 143±40 cm/s,respectively,the end diastolic velocity (EDV) were 159±22,68±16,68±14,and 66±17 cm/s,respectively,and the pulse index (PI) were 0.67±0.06,0.80±0.08,0.80±0.07,and 0.82±0.06,respectively.PSV,EDV,and PI at 1 d,7 d,and 3 months were improved compared with before procedure (all P0.05).Conclusions Initial analysis showed that no procedure-related complications were observed in the treatment of vascular tortuosity and complex middle cerebral artery stenosis with the Solitaire stents.The short-term curative effect is exact;However,it still needs to be validated further.
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Objective To evaluate the feasibility, safety and efficacy of Solitaire stent placement for treatment of complex intracranial atherosclerotic stenosis. Methods We retrospectively reviewed the clinical data of 18 patients who underwent Solitaire stent placement for symptomatic intracranial arterial stenoses in our department between November 2011 and June 2012, with focus on the stenosis morphology, condition of the diseased blood vessels, surgical success rate, and perioperative complications. We also summarized the early outcomes and imaging findings during follow-up. Results The patients included 8 males and 10 females, with a mean age of 66. 55 + 9. 84 years old. Mori typing results were 5 A, 8 B, and 5 C types; LMA typing results were good in 2, moderate tortuosity in 12, severe tortuosity in 4 cases. All the patients received successful Solitaire stent implantation. The average stenosis rate was reduced from (74 + 12. 5)% to (10 + 5. 5)% after the procedure. There was only one patient (5. 6%) had post-operative complication (cerebral infarction of the target vessel territory), who had temporal symptom and recovered well at follow-up. Clinical follow-up was available for 18 patients, with a mean of 6.2+ 1. 4 months; and no patients experienced any ischemic episodes. Fifteen patients had DSA or CTA follow-up for a mean of 7. 8 + 2. 6 months. There were 3 in-stent restenosis (20%) cases and one of them wassymptomatic with transient ischemic attack. Conclusion Solitaire stent placement is feasible, safe and effective for complex symptomatic intracranial artery stenosis, with definite short-term effectiveness, and the long-term effect warrants further investigation.