Sole angioplasty with tiny balloon for high-risk complex symptomatic intracranial atherosclerotic stenosis
10.3760/cma.j.issn.0529-5815.2018.06.014
- VernacularTitle: 单纯小球囊血管成形术治疗症状性颅内动脉粥样硬化性狭窄复杂病变的近期疗效分析
- Author:
Peng QI
1
;
Junjie WANG
;
Lijun WANG
;
Jun LU
;
Shen HU
;
Ximeng YANG
;
Kunpeng CHEN
;
Haifeng WANG
;
Daming WANG
Author Information
1. Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
- Publication Type:Journal Article
- Keywords:
Intracranial arteriosclerosis;
Angioplasty, balloon;
Treatment outcome
- From:
Chinese Journal of Surgery
2018;56(6):458-463
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the safety and short-term efficacy of sole angioplasty with tiny balloon for symptomatic intracranial atherosclerotic stenosis (ICAS) patients with complex lesions refractory.
Methods:Consecutive 11 patients with complex ICAS lesions treated by sole angioplasty with tiny balloon (diameter≤2 mm) from September 2016 to November 2017 at Department of Neurosurgery, Beijing Hospital were retrospectively reviewed. Patients′ demographics, lesions characteristics, procedures, complications, and clinical and imaging follow-up data were collected. There were 6 male and 5 female patients with mean age of 63.6 years (range: 45 to 77 years). Clinical manifestations were transient ischemia attack (TIA) in 4 cases, progressive ischemic stroke in 3 cases, recurrent stroke in 3 cases, and 1 case for preparation of scheduled radical resection of colon cancer. ICAS locations were middle cerebral artery M1 segment in 5 cases, M2 segment in 1 case, anterior cerebral artery A1 segment in 2 cases, and intracranial vertebral artery in 3 cases. Mean degree of ICAS stenosis was 92%. Lesion morphology was type A in 3 cases, B in 4 cases and C in 4 cases by Mori classification. Forward flow by modified thrombolysis in cerebral infarction (mTICI) was grade 1 to 2a in 8 cases, 2b in 3 cases. Collateral compensation grading was grade 2 in 5 cases, grade 3 in 6 cases.
Results:Technique success rate was 10/11, peri-procedural complication rate was 1/11. Post-procedural forward flow in all cases had been enhanced and 10 cases obtained mTICI 2b to 3. Ten patients got favorable outcomes (modified Rankin score 0 to 2) at discharge. With a mean clinical follow-up time of 5.4 months, 1 patient was found to have TIA recurrence. With a mean clinical follow-up time of 7.4 months, 1 patient was found to have TIA recurrence. Eight in 11 cases obtained imaging follow-up during 3 months, and none restenosis was found.
Conclusion:For symptomatic ICAS complex lesions, sole angioplasty with tiny balloon demonstrates relatively high safety with satisfactory short-term clinical and imaging results.
