Would Self-Expanding Stent Occlude Middle Cerebral Artery Perforators?

Thomas W. Leung, Simon C.H. Yu, Wynnie W.M. Lam, Anne Y. Y. Chan, Alexander Y.L. Lau, Lawrence K.S. Wong


Background and Purpose—A major concern of intracranial stenting is perforator infarction. It is unclear whether the sustained radial force of a self-expanding stent or subsequent stent restenosis would cause late occlusion of perforators.

Methods—We compared the baseline and poststent (≥4 months) MRI scans of patients who underwent self-expanding stenting for recurrent ischemic symptoms attributed to a MCA stenosis ≥60%. New infarcts in the ipsilateral striatocapsular region were recorded.

Results—MCA stenting was technically successful in 23 of 24 recruited patients. No new perforator territory infarct was found in follow-up MRI scans of all recruited patients. Postoperatively, all patients reported no further TIA or stroke over a median follow-up of 15 months.

Conclusions—The use of a self-expanding stent in patients with high-grade MCA stenosis may not pose a major risk to the perforators. (Stroke. 2009;40:1910-1912.)

Full Publication: http://stroke.ahajournals.org/content/40/5/1910.full.pdf