| The effectiveness of microballoon angioplasty in treating middle cerebral artery occlusion beyond the bifurcation. | |
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MedLine Citation:
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PMID: 20538827 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: PTA effectively treats vasospasm and arterial disease in peripheral, coronary, and large proximal cerebral vessels but rarely reaches small vessels like the distal MCA beyond the bifurcation. Our purpose was to evaluate the safety and efficacy of PTA for distal MCA occlusions in acute ischemic stroke. MATERIALS AND METHODS: Seven patients had strokes in branches of their MCAs. Following diagnostic angiography, all received microballoon angioplasty and various combinations of IA alteplase (rtPA), abciximab, and/or nitroglycerin. Two also underwent stent placement. Comprehensive retrospective review of the patients' records was performed. Patients' NIHSS scores were reassessed before discharge. Recanalization was evaluated by angiography after treatment and at follow-up. RESULTS: PTA was successfully performed in 7 patients without treatment-associated intracerebral hemorrhage. Two patients received distal MCA angioplasty as a secondary intervention: 1 following failed treatment with a Merci retriever and the other after successful removal of proximal clot with a Merci retriever. One patient did not recover from the initial ischemic event despite an excellent angiographic result. Complete recanalization (modified TIMI grade 4) was achieved in 4 patients and near-complete recanalization with mild flow deficit (modified TIMI grade 3), in 3 patients. CONCLUSIONS: PTA of the distal MCA with a microballoon is safe and effective for acute ischemic stroke. This case series demonstrates that endovascular treatment beyond the MCA bifurcation can dramatically reverse neurologic deficits. |
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Authors:
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E Gifford; D Drazin; J C Dalfino; A K Nair; J Yamamoto; A S Boulos |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2010-06-10 |
Journal Detail:
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Title: AJNR. American journal of neuroradiology Volume: 31 ISSN: 1936-959X ISO Abbreviation: AJNR Am J Neuroradiol Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-13 Completed Date: 2011-01-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8003708 Medline TA: AJNR Am J Neuroradiol Country: United States |
Other Details:
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Languages: eng Pagination: 1541-8 Citation Subset: IM |
Affiliation:
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Division of Neurosurgery, Albany Medical Center, Albany, NY, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adult Aged Aged, 80 and over Angioplasty, Balloon / methods* Brain Ischemia / radiography, therapy* Cerebral Angiography Cerebral Revascularization / methods* Female Follow-Up Studies Humans Infarction, Middle Cerebral Artery / radiography, therapy* Male Middle Aged Retrospective Studies Stents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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