Long-term outcome of balloon angioplasty without stenting for symptomatic middle cerebral artery stenosis

Abstract

The purpose of this study is to assess perioperative and long-term outcome of balloon angioplasty without stenting for symptomatic middle cerebral artery (MCA) stenosis. We retrospectively analyzed the clinical and angiographic data of 58 patients (mean age 59 years old) with 66 balloon angioplasty without stenting for high-grade (>70%) atherosclerotic stenosis of the main trunk of MCA between 1993 and 2007. All patients had experienced recurrent transient ischemic attack (TIA) or minor stroke resistant to medical treatment and significant perfusion problems in MCA territory. The period of follow-up was mean 64 months (6–171 months) in 50 patients. Balloon angioplasty was successfully in 89%. Symptomatic dissection with major stroke occurred in 1 patient. Minor stroke without neurological deterioration occurred in 2 patients. Asymptomatic dissections occurred in 5 patients. Restenosis occurred in 10 patients at mean 19±12 months after treatment. Occlusion of MCA occurred in 5 patients at mean 50 months. Recurrent of stroke and TIA occurred in 6 patients at mean 52 months. Balloon angioplasty without stenting for symptomatic MCA stenosis can be performed with a high successful rate and a low risk of complications. Long-term clinical follow-up data suggest that this procedure reduces the risk of further stroke.