Would self-expanding stent occlude middle cerebral artery perforators?
OBJECTIVE
A major concern of intracranial stenting is perforator infarction. It is unclear whether the sustained radial force of a self-expanding stent or subsequent stent restenosis would cause late occlusion of perforators.


METHODS
We compared the baseline and poststent (>or=4 months) MRI scans of patients who underwent self-expanding stenting for recurrent ischemic symptoms attributed to a MCA stenosis >or=60%. New infarcts in the ipsilateral striatocapsular region were recorded.


RESULTS
MCA stenting was technically successful in 23 of 24 recruited patients. No new perforator territory infarct was found in follow-up MRI scans of all recruited patients. Postoperatively, all patients reported no further TIA or stroke over a median follow-up of 15 months.


CONCLUSIONS
The use of a self-expanding stent in patients with high-grade MCA stenosis may not pose a major risk to the perforators.
Leung
Thomas W
TW
Department of Medicine and Therapeutics, Division of Neurology, Prince of Wales Hospital, The Chinese University of Hong Kong. drtleung@cuhk.edu.hk
Yu
Simon C H
SC
Lam
Wynnie W M
WW
Chan
Anne Y Y
AY
Lau
Alexander Y L
AY
Wong
Lawrence K S
LK
D000328:Adult; D000368:Aged; D017130:Angioplasty; D001241:Aspirin / Q000627:therapeutic use; D000077144:Clopidogrel; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000209:etiology*; D002546:Ischemic Attack, Transient / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011446:Prospective Studies; D015607:Stents / Q000009:adverse effects*; D020521:Stroke / Q000601:surgery*; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin