title: Randomized controlled trial of symptomatic middle cerebral artery stenosis: endovascular versus medical therapy in a Chinese population.
abstract: OBJECTIVE
  To investigate the efficacy and safety of percutaneous transluminal angioplasty and stenting (PTAS) for symptomatic middle cerebral artery stenosis compared with standard medical treatment in a low-risk Chinese population.
  
  
  METHODS
  A prospective, randomized, controlled, single-center clinical trial was conducted comparing PTAS with medical treatment for symptomatic middle cerebral artery stenosis (≥70%). Patients were enrolled according to 1:1 enroll ratio (PTAS: medical). The PTAS group received stenting or balloon angioplasty, whereas the medical treatment group received standard medical treatment (aspirin 100mg plus clopidogrel 75 mg/d), and all the patients were under strict control of the risk factors. The end point events were any kind of ipsilateral stroke or transient ischemic attack, or death from any origin during 1-year follow-up.
  
  
  RESULTS
  The enrollment was stopped after 70 patients were enrolled from August 2007 to December 2010, with a 30-day rate of end point events of 8.3% versus 5.9% (P=0.69) for PTAS and medical group, respectively, and 1-year rate of end point events of 19.4% versus 17.6% (P=0.85), respectively. There was no significant difference in baseline characteristics between the 2 groups. The mean follow-up time, which was ongoing, was 9.9±3.9 and 9.7±4.4 months, respectively. Among the risk factors, hypertension was the independent related to the outcome (P=0.015).
  
  
  CONCLUSIONS
  This study showed that endovascular treatment is as safe but not better than medical treatment for symptomatic middle cerebral artery stenosis in a low-risk Chinese population. History of hypertension increases the risk of recurrent ischemic events.
authors.affiliation: Department of Neurosurgery, Center for interventional diagnosis and treatment, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Zhongrong
authors.initials: Z
authors.lastname: Miao
authors.forename: Lidan
authors.initials: L
authors.lastname: Jiang
authors.forename: Hao
authors.initials: H
authors.lastname: Wu
authors.forename: Yuhai
authors.initials: Y
authors.lastname: Bao
authors.forename: Liqun
authors.initials: L
authors.lastname: Jiao
authors.forename: Shenmao
authors.initials: S
authors.lastname: Li
authors.forename: Jian
authors.initials: J
authors.lastname: Wu
authors.forename: Yang
authors.initials: Y
authors.lastname: Hua
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Junlei
authors.initials: J
authors.lastname: Zhu
authors.forename: Fengshui
authors.initials: F
authors.lastname: Zhu
authors.forename: Xuezong
authors.initials: X
authors.lastname: Liu
authors.forename: Feng
authors.initials: F
authors.lastname: Ling
mesh_terms: D000328:Adult; D000368:Aged; D017130:Angioplasty / Q000009:adverse effects / Q000379:methods*; D044466:Asian People / Q000706:statistics & numerical data*; D001241:Aspirin / Q000008:administration & dosage; D000077144:Clopidogrel; D003920:Diabetes Mellitus / Q000208:ethnology; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006949:Hyperlipidemias / Q000208:ethnology; D006973:Hypertension / Q000208:ethnology; D020244:Infarction, Middle Cerebral Artery / Q000188:drug therapy / Q000208:ethnology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D011446:Prospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D015607:Stents / Q000009:adverse effects; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin