Endovascular Therapy for Intracranial Artery Stenosis: Results from the Japanese Registry of Neuroendovascular Therapy (JR-NET)3

Izumi, Tohru; Nishibori, Masahiro; Imamura, Hirotoshi; Iihara, Koji; Sakai, Nobuyuki; investigators, Jr-Net

doi:10.2176/nmc.oa.2019-0271

Cited by 5 publications

(2 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 10 ] Although most cases are caused by manipulations such as vascular perforation (0.9%) and vessel rupture (0.8%), hemorrhage induced by hyperperfusion syndrome has been reported to be as low as 0.2%. [ 6 ] In the present case, the nearly occluded AChA was incidentally recanalized after the procedure, suggesting the involvement of hyperperfusion syndrome in the process of hemorrhagic transformation. In accordance with our findings, hyperperfusion of the basal ganglia is associated with subsequent hemorrhage after endovascular recanalization in patients with ischemic stroke.…”

Section: Discussionmentioning

confidence: 56%

Potential hemorrhagic risk of endovascular revascularization therapy due to recanalization of the dissected perforator in intracranial internal carotid artery dissection: A case report

Ishida

Sakata

Ezura

et al. 2022

Surgical Neurology International

View full text Add to dashboard Cite

Background: Intracranial internal carotid artery (ICA) dissection manifesting as ischemic stroke is rare. Although endovascular revascularization therapy is effective in preventing the progression of stroke, little is known about the potential risk of this therapeutic approach. Case Description: We report a case of a 38-year-old woman who presented with acute ischemic infarcts in the territory of the left anterior choroidal artery (AChA) due to intracranial ICA dissection. She underwent balloon angioplasty, resulting in the complete resolution of the stenosis. The AChA, which was nearly occluded preoperatively, was unexpectedly recanalized after the procedure. Four hours later, she developed a parenchymal hemorrhage in the left basal ganglia without subarachnoid hemorrhage. The AChA, suspected as the hemorrhagic source during surgical hematoma removal, was revealed to have a disrupted internal elastic lamina on pathological examination, suggesting that the dissection of the ICA extended to the AChA. Conclusion: To the best of our knowledge, this is the first case report demonstrating that the intracranial ICA dissection extends to the associated perforator. Considering the potential risk of subsequent hemorrhagic complications by recanalization of the dissected perforator, prudent postoperative management, including strict blood pressure control, is advisable following endovascular revascularization therapy against intracranial artery dissection involving perforators.

show abstract

Section: Discussionmentioning

confidence: 56%

Potential hemorrhagic risk of endovascular revascularization therapy due to recanalization of the dissected perforator in intracranial internal carotid artery dissection: A case report

Ishida

Sakata

Ezura

et al. 2022

Surgical Neurology International

View full text Add to dashboard Cite

show abstract

“…However, other intracranial stents for coil embolization and coronary stents are practically used for such intracranial stenotic lesions, because they can easily be deployed. [ 11 ] Wingspan is an open-cell, self-expanding stent that is guided over-the-wire stent housed in a specialized outer sheath. The guidance of Wingspan may be difficult or the stent may not be deployed in the distal access.…”

Section: Discussionmentioning

confidence: 99%

Anterior cerebral artery dissection for a patient with ipsilateral aplastic or twig-like middle cerebral artery: An illustrative case report

Terakado

Matsumaru²,

Ishikawa

2023

Surgical Neurology International

View full text Add to dashboard Cite

Background: An aplastic or twig-like middle cerebral artery (Ap/T-MCA) is a rare anomaly, which sometimes causes ischemic infarction. Collateral flow from the ipsilateral anterior cerebral artery (ACA) is important for patients with Ap/T-MCA. If ipsilateral ACA stenosis or occlusion occurs, a large infarction with a wider field than the ACA territory could happen. First, mechanical thrombectomy was performed for the right ACA near occlusion caused by arterial dissection with ipsilateral Ap/T-MCA in this case. Second, Wingspan stenting was performed for the right ACA restenosis. Case Description: A 77-year-old female presented to the hospital with the left hemiparesis. We diagnosed a right ACA infarction caused by right ACA occlusion. Digital subtraction angiography showed right Ap/T-MCA and ipsilateral ACA near occlusion. Thrombectomy was performed, and recanalization was achieved with mild ACA stenosis. The lesion was the dissection due to angiographical finding. Two months after treatment, transient left hemiparesis occurred and right ACA stenosis progressed. Computed tomography perfusion showed hypoperfusion of the right hemisphere. Wingspan stenting was performed from the left internal carotid artery through the anterior communicating artery with an intermediate catheter. The patient was discharged without any neurological deficit. Conclusion: We reported the first case of a patient who underwent Wingspan stenting for the right ACA dissection with Ap/T-MCA. Short-term follow-up and aggressive intervention should be considered for collateral pathway dissection with Ap/T-MCA because the symptoms can become serious. The patients with Ap/T-MCA should be cautious about the collateral pathway arterial changes in particular ipsilateral ACA due to the increasing hemodynamic stress.

show abstract

Improvement of cerebral blood flow after balloon angioplasty and stenting for symptomatic middle cerebral artery stenosis

Araga,

Ueda,

Yoshie

et al. 2024

Interv Neuroradiol

View full text Add to dashboard Cite

Objective Although reports of endovascular treatment for intracranial arterial stenosis have been increasing recently, their efficacy remains to be elucidated. This study aimed to investigate the changes in cerebral hemodynamics of severe middle cerebral artery (MCA) stenosis patients by performing CT perfusion (CTP) after endovascular treatment. Methods Subjects were those who underwent balloon angioplasty and stenting for symptomatic MCA M1 stenosis refractory to medical therapy at our hospital between 2008 and 2022. We included 36 patients (mean age 63.69 ± 15.24 years, 20 males) who underwent CTP before and within three weeks after treatment. The CTP parameters such as relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), and relative mean transit time (rMTT) were calculated as ipsilateral values divided by contralateral value. Results Endovascular treatment consisted of 26 balloon angioplasty and 10 stenting procedures performed at an average of 1 month from onset. CTP was performed at an average of 5.5 days postoperatively. The mean overall stenosis rate decreased from 79.0% to 30.3%. In the balloon angioplasty group, it decreased from 77.6% to 35.3%, and in the stent group, it decreased from 82.7% to 17.5%. After treatment, rCBF and rMTT measured by CTP improved significantly (both p < 0.001), whereas there was no significant change in rCBV. The improvement rates of rCBF and rMTT were mild higher in the stent group, but not significantly so. Conclusion Balloon angioplasty and stenting for symptomatic MCA improved cerebral hemodynamics, resulting in significantly increased rCBF and decreased rMTT.

show abstract

Endovascular Therapy for Intracranial Artery Stenosis: Results from the Japanese Registry of Neuroendovascular Therapy (JR-NET)3

Cited by 5 publications

References 14 publications

Potential hemorrhagic risk of endovascular revascularization therapy due to recanalization of the dissected perforator in intracranial internal carotid artery dissection: A case report

Potential hemorrhagic risk of endovascular revascularization therapy due to recanalization of the dissected perforator in intracranial internal carotid artery dissection: A case report

Anterior cerebral artery dissection for a patient with ipsilateral aplastic or twig-like middle cerebral artery: An illustrative case report

Improvement of cerebral blood flow after balloon angioplasty and stenting for symptomatic middle cerebral artery stenosis

Contact Info

Product

Resources

About