Percutaneous balloon-angioplasty and intracranial deployment of stents for symptomatic middle cerebral artery stenosis

Objective To discusses the indications, technical feasibility and effectiveness of endovascular treatment for symptomatic MCA stenosis. Methods Fourteen cases with symptomatic MCA stenosis treated by endovascular methods were reviewed respectively. Of the 14 cases, 9 cases were treated only by balloon angioplasty before 2001, and 5 cases were treated using new generation of coronary stent by stent assistant angioplasty. Results 5 of 9 cases using balloon angioplasty were successfully dilated for the mean stenosed segment from 67% to 18% at the instant angiography after procedures. 2 cases had technical failure because of the tortuous vasculature, and 2 cases encountered technical related complication including one elastic recoil and one vessel rupture, the patient with vessel rupture deteriorated and died 4 days after procedure. For 5 cases with stent-assistant angioplasty,successful deployment of the coronary stents were achieved in 4 cases. The mean stenosed segment were dilated from 85% to 10%. The vessel rupture occurred in 1 case after the stent navigated through the narrowed segment. No stroke attacked at a short follow-up period(3-5 months). Conclusion Both single balloon and stent-assistant angioplasty are effective for treatment of symptomatic MCA stenosis, the latter method showed more advantages, but it needs further and long term follow-up study.