Follow-up study after percutaneous transluminal cerebral angioplasty

Abstract

The purpose of this study was to assess the safety and efficacy of percutaneous transluminal cerebral balloon angioplasty (PTCBA) of extra- and intra-cranial arteries by investigating procedural outcome. Eighty haemodynamically significant extra- and intra-cranial lesions (% diameter stenosis > 70) in 74 clinically symptomatic patients were treated by elective and initial PTCBA between March 1991 and February 1996 and thereafter followed. Death, stroke, surgery, or repeated angioplasty of restenosis or new lesions were regarded as cerebral events after the initial PTCBA. The procedural and clinical success rates were 81 % (65 of 80) and 81 % (60 of 74), respectively. Progressively ischaemic symptoms disappeared completely after clinically successful dilatation. Angiographic restenosis rate at 3 months was 22 %(14 of 65). By life-table method, the death/stroke risk was 16 %, and any cerebral event risk was 49 % at 2 years following PTCBA, respectively. The most common of first cerebral events presented was repeated angioplasty of restenosis. In conclusion, PTCBA has great efficacy in decreasing recurrent neurological symptoms and produces a favourable short-term outcome, whereas restenosis limits long-term benefit.

Drug-Eluting Stents for the Treatment of Intracranial Atherosclerosis

“…2,3 The ultimate goal of stenting is to maintain adequate cerebral perfusion over the lifetime of the patient; by preventing restenosis with DES, patients may be spared the risk of recurrent ischemia, as well as the risks associated with intracranial interventions, which may be between 10% and 30%. 5,6 The histological structure of the intracranial arteries differs from that of the coronary arteries, and, as a consequence, there are theoretical risks (eg, vessel toxicity and delayed endothelialization) associated with DES that are not associated with BMS. Vessel toxicity occurs by a direct effect of the drugs.…”

Angioplasty for Acute Stroke With Pediatric Moyamoya Syndrome

“…Although evidence of long-term benefit in secondary stroke prevention of adult atherosclerotic disease is limited, there is a shortterm reduction of recurrent neurological symptoms after balloon angioplasty. 6 Prospective studies are lacking. Retrospective studies vary in the stroke and death rate, from 4% to 40%.…”

Reporting standards for angioplasty and stent-assisted angioplasty for intracranial atherosclerosis

“…Drugs used for this purpose are nitroglycerin83 or isosorbide dinitrate (1.25 to 5.0 mg as a single bolus) 102 103. Other agents include calcium channel blockers such as nicardipine and verapamil as well as papaverine.…”