Endovascular revascularization of symptomatic chronic middle cerebral artery occlusions: Two case reports

Wan, Yue; Lo, Wai-Ting; Liu, Yang-Xia; Peng, Xiaoxiang

doi:10.1177/1591019915617316

Cited by 5 publications

(1 citation statement)

References 10 publications

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“…However, in clinic, the effects of conventional medical drugs in the treatment of progressive stroke caused by intracranial macrovascular occlusion are relatively weak, and no effective treatment is available for preventing disease deterioration. Some studies have found that it is safe for patients with progressive stroke caused by intracranial macrovascular occlusion over the time window to receive endovascular treatment after ineffective medical drug therapy, which could improve the prognosis of neurological function [9,10]. The results of the DAWN trial support the benefit of thrombectomy in patients with anterior circulation LVO acute stroke presenting within 6-24 hours from time last known well.…”

Section: Introductionmentioning

confidence: 96%

Safety and efficacy of intravascular therapy in patients with progressive stroke caused by intracranial large vascular occlusion exceeding the time window of 24 hours

Zhang

Chen

et al. 2021

Neurological Research

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Purpose: To compare endovascular and drug therapies for efficacy and safety in patients with a progressive stroke caused by intracranial large vascular occlusion exceeding the time window of 24 hours. Patients and methods: A total of 58 patients with progressive stroke caused by large intracranial vascular occlusion exceeding the time window of 24 hours treated in the stroke center of our hospital for three years were retrospectively analyzed . According to the applied therapy, 58 patients were divided into the endovascular (n = 19) and drug (n = 39) therapy groups. Then, modified Rankin scale (mRS) scores, symptomatic intracranial hemorrhage rates, mortality rates and adverse events were assessed in both groups within 90 days. Results: The 90-day good prognosis rate was significantly higher in the endovascular therapy group compared with the drug group (68.4% VS 38.5%, odds ratio [OR] = 0.29; 95% confidence interval [CI], 0.09-0.92; P = 0.032). The 90-day NIHSS scores were lower in the endovascular therapy group compared with the drug group (3.3 ± 2.6 VS 5.2 ± 3.0, OR = −1.89; 95%CI, −3.50 to −0.27; P = 0.023). Meanwhile, the proportion of patients with a Barthel index of 90-100 was significantly higher in the endovascular therapy group compared with the drug group (53.0% VS 25.6%, OR = 0.31; 95%CI, 0.10-0.98; P = 0.042). Finally, both groups showed similar rates of adverse events. Conclusion:In patients with progressive stroke caused by large intracranial vascular occlusion exceeding 24 hours, endovascular therapy probably results in improved efficacy at 90 days compared with drug therapy, without increasing the rates of adverse effects.

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Section: Introductionmentioning

confidence: 96%

Safety and efficacy of intravascular therapy in patients with progressive stroke caused by intracranial large vascular occlusion exceeding the time window of 24 hours

Zhang

Chen

et al. 2021

Neurological Research

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Collateral circulation predicts 3-month functional outcomes of subacute ischemic stroke patients: A study combining arterial spin labeling and MR angiography

Wu¹,

Zhou²,

Zhang³

et al. 2023

European Journal of Radiology

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Endovascular recanalisation with drug coated balloon for chronic symptomatic middle cerebral artery total occlusion

Zhang

et al. 2018

BMJ Case Reports

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The optimal treatment for patients with chronic symptomatic middle cerebral artery (MCA) total occlusion is not well established. In addition to medical therapy, vessel recanalisation with stenting has shown much promise, especially for patients with recurrent ischemic symptoms. Nevertheless, the incidence of symptomatic in-stent restenosis (ISR) is high, and is associated with an unfavorable prognosis. Drug coated balloons (DCBs) have been proven to be effective in treating and preventing ISR. However, the feasibility of DCBs for de novo intracranial atherothrombotic stenosis has not been previously described, especially for total occlusion lesions. Here we reported a patient with chronic left MCA total occlusion successfully treated with DCBs, with a good outcome at the 1 year follow-up. More studies are warranted to further compare the efficacy of DCBs and stentings for intracranial revascularisation.

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Endovascular revascularization of symptomatic chronic middle cerebral artery occlusions: Two case reports

Cited by 5 publications

References 10 publications

Safety and efficacy of intravascular therapy in patients with progressive stroke caused by intracranial large vascular occlusion exceeding the time window of 24 hours

Safety and efficacy of intravascular therapy in patients with progressive stroke caused by intracranial large vascular occlusion exceeding the time window of 24 hours

Collateral circulation predicts 3-month functional outcomes of subacute ischemic stroke patients: A study combining arterial spin labeling and MR angiography

Endovascular recanalisation with drug coated balloon for chronic symptomatic middle cerebral artery total occlusion

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