Long-Term Durability of Percutaneous Transluminal Angioplasty in Patients with Symptomatic Middle Cerebral Artery Stenosis

BACKGROUND AND PURPOSE: Percutaneous transluminal angioplasty (PTA) is being increasingly used in the treatment of symptomatic middle cerebral artery (MCA) stenosis. We evaluated the long-term durability after PTA for symptomatic MCA stenosis. METHODS: We analyzed consecutive patients included in our stroke database who were treated with angioplasty alone. The subjects without major periprocedural complications were followed up for at least 42 months. Recurrent ischemic symptoms were defined as newly developed episodes of transient ischemic attack or ischemic stroke in the territory of the treated vessel. Stroke was defined as ischemic stroke in any vessel. RESULTS: PTA was technically successful in 37 of the 40 included patients. Thirty-two of the 37 patients were followed up at regular intervals of 1 to 6 months in the outpatient clinic of our institution for at least 42 months. Restenosis occurred in 3 of the 32 patients (9.4%) within 2 years of PTA, and no restenosis was identified thereafter. Two of the three patients with restenosis had asymptomatic complications such as dissection and vasospasm during the intervention. The ischemic area was in the treated vessel in 1 of the 32 patients and in other vessels in 3 of the 32 patients (9.4%). CONCLUSIONS: Successful PTA can result in a low rate of recurrent ischemic symptoms, and restenosis during a long-term follow-up appears to be more frequent in the early period.