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Cerebral artery restenosis following transluminal balloon angioplasty for vasospasm after subarachnoid hemorrhage.

Umeoka K, Kominami S, Mizunari T, Murai Y, Kobayashi S, Teramoto A - Surg Neurol Int (2011)

Bottom Line: We compared the size of the cerebral artery on the PTA and the contralateral side.All 32 patients underwent successful PTA of 38 vascular territories and all manifested angiographic improvement of vasospasm.PTA resulted in a significant improvement in the vessel diameter in patients with vasospasm after SAH and they did not suffer restenosis in the course of prolonged follow-up.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neurosurgery, Nippon Medical School, Chiba-Hokusou Hospital, 1715 Kamakari, Inzaishi, Chiba, 270-1694, Japan.

ABSTRACT

Background: Although percutaneous transluminal angioplasty (PTA) is a widely used less invasive method to treat coronary artery stenosis, 10% of treated patients experience restenosis. Restenosis also occurs in approximately 5% of patients subjected to carotid artery stenting. Animal and human data suggested that restenosis is a response to injury incurred during PTA. As PTA has come into wide use to manage symptomatic cerebral vasospasm after subarachnoid hemorrhage (SAH) we studied the incidence of restenosis after PTA for cerebral vasospasm.

Methods: Our study population consisted of 32 patients who had undergone PTA. They were followed by cerebral or 3DCT angiography or MRA for 6 126 months post-PTA (mean 48.65 months) to diagnose restenosis of the cerebral artery. We compared the size of the cerebral artery on the PTA and the contralateral side.

Results: All 32 patients underwent successful PTA of 38 vascular territories and all manifested angiographic improvement of vasospasm. None suffered restenosis during the follow up period.

Conclusion: PTA resulted in a significant improvement in the vessel diameter in patients with vasospasm after SAH and they did not suffer restenosis in the course of prolonged follow-up.

No MeSH data available.


Related in: MedlinePlus

(a) Left internal carotid arteriogram (frontal view) showing severe vasospasm of the M1 portion of the MCA and the A1 portion of the ACA. (b) Angiogram obtained immediately after angioplasty showing the MCA to be normal in size. (c) 3D-CTA obtained 50 months after percutaneous transluminal angioplasty. There is no evidence of MCA restenosis
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Figure 1: (a) Left internal carotid arteriogram (frontal view) showing severe vasospasm of the M1 portion of the MCA and the A1 portion of the ACA. (b) Angiogram obtained immediately after angioplasty showing the MCA to be normal in size. (c) 3D-CTA obtained 50 months after percutaneous transluminal angioplasty. There is no evidence of MCA restenosis

Mentions: A 36 year old woman presented with massive SAH due to a dorsal aneurysm at the left internal carotid artery (Hunt and Hess grade III, Fisher group 3). She underwent trapping of the left internal carotid artery and a radial artery external carotid artery bypass involving the M2 portion of the MCA. Although she responded well to verbal commands after the operation, one week later she developed consciousness disturbance; the mean TCD velocity was increased to 140 cm/s. Emergent angiography demonstrated severe spasms of the M1 portion of the MCA and the A1 portion of the ACA [Figure 1a]. Immediate PTA to the M1 portion of the MCA resulted in normalization of the vessel size [Figure 1b]; her consciousness disturbance improved and the mean TCD velocity was 80 cm/sec. She was discharged 1 month later without neurological deficit. She was followed at regular intervals and 3DCTA obtained 50 months after PTA yielded no evidence of MCA restenosis [Figure 1c].


Cerebral artery restenosis following transluminal balloon angioplasty for vasospasm after subarachnoid hemorrhage.

Umeoka K, Kominami S, Mizunari T, Murai Y, Kobayashi S, Teramoto A - Surg Neurol Int (2011)

(a) Left internal carotid arteriogram (frontal view) showing severe vasospasm of the M1 portion of the MCA and the A1 portion of the ACA. (b) Angiogram obtained immediately after angioplasty showing the MCA to be normal in size. (c) 3D-CTA obtained 50 months after percutaneous transluminal angioplasty. There is no evidence of MCA restenosis
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3108445&req=5

Figure 1: (a) Left internal carotid arteriogram (frontal view) showing severe vasospasm of the M1 portion of the MCA and the A1 portion of the ACA. (b) Angiogram obtained immediately after angioplasty showing the MCA to be normal in size. (c) 3D-CTA obtained 50 months after percutaneous transluminal angioplasty. There is no evidence of MCA restenosis
Mentions: A 36 year old woman presented with massive SAH due to a dorsal aneurysm at the left internal carotid artery (Hunt and Hess grade III, Fisher group 3). She underwent trapping of the left internal carotid artery and a radial artery external carotid artery bypass involving the M2 portion of the MCA. Although she responded well to verbal commands after the operation, one week later she developed consciousness disturbance; the mean TCD velocity was increased to 140 cm/s. Emergent angiography demonstrated severe spasms of the M1 portion of the MCA and the A1 portion of the ACA [Figure 1a]. Immediate PTA to the M1 portion of the MCA resulted in normalization of the vessel size [Figure 1b]; her consciousness disturbance improved and the mean TCD velocity was 80 cm/sec. She was discharged 1 month later without neurological deficit. She was followed at regular intervals and 3DCTA obtained 50 months after PTA yielded no evidence of MCA restenosis [Figure 1c].

Bottom Line: We compared the size of the cerebral artery on the PTA and the contralateral side.All 32 patients underwent successful PTA of 38 vascular territories and all manifested angiographic improvement of vasospasm.PTA resulted in a significant improvement in the vessel diameter in patients with vasospasm after SAH and they did not suffer restenosis in the course of prolonged follow-up.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neurosurgery, Nippon Medical School, Chiba-Hokusou Hospital, 1715 Kamakari, Inzaishi, Chiba, 270-1694, Japan.

ABSTRACT

Background: Although percutaneous transluminal angioplasty (PTA) is a widely used less invasive method to treat coronary artery stenosis, 10% of treated patients experience restenosis. Restenosis also occurs in approximately 5% of patients subjected to carotid artery stenting. Animal and human data suggested that restenosis is a response to injury incurred during PTA. As PTA has come into wide use to manage symptomatic cerebral vasospasm after subarachnoid hemorrhage (SAH) we studied the incidence of restenosis after PTA for cerebral vasospasm.

Methods: Our study population consisted of 32 patients who had undergone PTA. They were followed by cerebral or 3DCT angiography or MRA for 6 126 months post-PTA (mean 48.65 months) to diagnose restenosis of the cerebral artery. We compared the size of the cerebral artery on the PTA and the contralateral side.

Results: All 32 patients underwent successful PTA of 38 vascular territories and all manifested angiographic improvement of vasospasm. None suffered restenosis during the follow up period.

Conclusion: PTA resulted in a significant improvement in the vessel diameter in patients with vasospasm after SAH and they did not suffer restenosis in the course of prolonged follow-up.

No MeSH data available.


Related in: MedlinePlus