Improvement of Cerebrovascular Reserve by Percutaneous Transluminal Angioplasty for Symptomatic Middle Cerebral Artery Stenosis

• Published in: Journal of Neuroendovascular Therapy 2021, Vol.15(1), pp.24-31
• Main Authors: Higashida, Tetsuhiro, Uchida, Takanori, Osakabe, Manabu, Takahashi, Yuichi, Kanazawa, Ryuzaburo
• Format: Article
• Language: English
• Subjects: cerebrovascular reserve; middle cerebral artery stenosis; Original; percutaneous transluminal angioplasty; single-photon emission computed tomography
• ISSN: 1882-4072; 2186-2494
• DOI: 10.5797/jnet.oa.2020-0046

Objective: The purpose of this study was to investigate the efficacy of percutaneous transluminal angioplasty (PTA) for symptomatic middle cerebral artery stenosis by analyzing cerebral blood flow (CBF).Methods: Between January 2016 and December 2018, six patients with symptomatic middle cerebral artery stenosis underwent CBF analysis by single-photon emission computed tomography (SPECT) with acetazolamide challenge before and after PTA for stenosis. They were retrospectively reviewed, and the blood flow in the area of the affected middle cerebral artery before and after angioplasty was compared.Results: The mean stenosis rate and length of lesion before angioplasty were 76.4 ± 5.4% and 6.5 ± 2.1 mm, respectively. Balloon angioplasty without stenting was performed on all patients. The mean residual stenosis rate just after angioplasty was 45.4 ± 9.3%. No periprocedual complications developed, and there were no notable cerebral ischemic events during the postprocedural follow-up period. One patient underwent repeat angioplasty for restenosis. Although there was only a mild decrease in blood flow at rest, the cerebrovascular reserve (CVR) in the area of the affected middle cerebral artery was markedly decreased before angioplasty (mean, 3.6 ± 4.3%). After angioplasty, the CVR was significantly improved (mean, 18.0 ± 4.7%, p