Document Detail

Morphological changes after percutaneous transluminal angioplasty.
MedLine Citation:
PMID:  10199293     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Percutaneous transluminal angioplasty (PTA) dilates constricted arteries at the circle of Willis to reverse cerebral ischemia caused by cerebral vasospasm. Although 90% of the patients show angiographic improvement after PTA, only 70% show clinical improvement. Why some patients do not improve after PTA is unknown. We report on a 48-year-old woman who failed to improve after PTA and died from aneurysm rerupture. Pathologic studies were performed to determine why PTA failed to reverse the symptoms of cerebral ischemia. METHODS: The arteries of the brain were studied by light microscopy using Gomori's trichrome stain. The arteries were also studied by scanning and transmission electron microscopy. RESULTS: The arteries that were dilated with PTA showed compression of the connective tissue, stretching of the internal elastic lamina, and a combination of compression and stretching of the smooth muscle. The small arteries and arterioles that had been treated with an infusion of intraarterial papaverine were constricted with a thickened intimal layer. CONCLUSION: The persistence of cerebral vasospasm in small and perforating arteries may contribute to the failure of cerebral ischemia to reverse after PTA.
A Y Zubkov; A I Lewis; D Scalzo; D H Bernanke; H L Harkey
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Surgical neurology     Volume:  51     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-04-16     Completed Date:  1999-04-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  399-403     Citation Subset:  IM    
Department of Neurosurgery, The University of Mississippi Medical Center, Jackson 39216-4505, USA.
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MeSH Terms
Angioplasty, Balloon*
Brain Ischemia / etiology,  pathology*,  therapy*
Cerebral Angiography
Ischemic Attack, Transient / complications,  pathology*,  therapy*
Microscopy, Electron
Middle Aged
Ultrasonography, Doppler, Transcranial

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