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Objective: ( a ) preliminary study endovascular stenting for symptomatic middle cerebral artery stenosis efficacy and safety . ( 2 ) to explore the techniques and perioperative prevention of complications . Methods : 26 patients with symptomatic middle cerebral artery stenosis in patients with transient ischemic attack in 5 cases, 21 cases of cerebral infarction , the use of balloon-expandable stent or Wingspan self-expanding stents for endovascular stent . 20 males and 6 females , aged 41 to 69 years, mean age 54.6 ± 8.3 years old. Horizontal middle cerebral artery (M1) 72.5% ~ 97.3% stenosis , mean (83.2 ± 6.5)%. Preoperative transcranial Doppler (TCD), CT or MRI, head MRA, CTA and cerebral angiography (DSA) and other tests , and make the U.S. National Institutes of Health Stroke Scale score (NIHSS). Under the supervision of the DSA , using local or general anesthesia , sedation and analgesia conventional ECG oxygen saturation monitoring , through the femoral artery puncture , using a modified Seldinger method in the right femoral artery puncture 6F arterial sheath placement , use the 6F Envoy guide catheter (Cordis corporation), in 0.014inch micro guide wire along the micro- guidewire into self-expanding Wingspan stent or balloon-expandable stents, stent location and release angiography to determine instantly observe the stent angiographic case , stenosis rate changes observed in patients with perioperative complications and treatment, after 1 month assessment NIHSS score . All cases of clinical follow-up. Results ( 1 ) 26 cases of 22 patients with MCAS successful stent placement , 20 cases of self-expanding Wingspan stent , two cases of balloon-expandable stent , the success rate was 84.6% ; stenosis rate (83.2 ± 6.5)% reduced ( 17.5 ± 6.6)%, P lt; 0.01, there are significant gaps ; preoperative and postoperative January NIHSS scores between P lt; 0.01, there are significant gaps ; stent implantation failure in 4 cases, 2 cases of internal carotid artery siphon excessive tortuosity , brackets difficult to pass ; total of nine cases of perioperative complications , the incidence is 34.6% , of which significant neurological deficit four cases ( 15.4% ) ; 1 case of death of vascular rupture , 6 cases ( 23.1% ) occurred vasospasm, two cases of acute thrombosis ; total of three cases of stent implantation in cerebral infarction occurred within 1 week . ( 2 ) with the imitation of 22 cases , with an average follow-up 16.6 ± 7.1M, non- recurrent TIA, stroke , TCD, CTA or DSA examination found no restenosis. Conclusion Endovascular stent treatment of symptomatic MCAS term effect is good, there are some complications , randomized controlled trials and long-term effect needs further study.
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