Would self-expanding stent occlude middle cerebral artery perforators?

Stroke. 2009 May;40(5):1910-2. doi: 10.1161/STROKEAHA.108.532416. Epub 2009 Jan 29.

Abstract

Background and purpose: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Angioplasty
  • Aspirin / therapeutic use
  • Clopidogrel
  • Female
  • Follow-Up Studies
  • Humans
  • Infarction, Middle Cerebral Artery / etiology*
  • Ischemic Attack, Transient / surgery*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors / therapeutic use
  • Prospective Studies
  • Stents / adverse effects*
  • Stroke / surgery*
  • Ticlopidine / analogs & derivatives
  • Ticlopidine / therapeutic use

Substances

  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Ticlopidine
  • Aspirin