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KMID : 1103720170760060403
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Journal of the Korean Society of Radiology
2017 Volume.76 No. 6 p.403 ~ p.410
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Emergent Intracranial Balloon Angioplasty and Bailout Self-Expandable Stent Placement in Acute Large Vessel Occlusion of the Anterior Circulation: Experience of a Single Institution
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Heo Young-Jin
Seo Jung-Hwa
Jeong Hae-Woong
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Abstract
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Purpose: To evaluate the outcomes of angioplasty for recanalization after acute ischemic stroke (AIS).
Materials and Methods: The study population was selected from 134 patients who underwent endovascular revascularization therapy (ERT) for AIS between October 2011 and May 2014. Of those 134 patients, 39 who underwent balloon angioplasty with or without stent insertion were included in this study. Balloon angioplasty was the primary treatment for nine patients and a rescue method for 30 patients. The revascularization rate at 7 days, procedure-related complications, and clinical outcomes at 3 months were analyzed.
Results: The occlusion sites were the middle cerebral artery (n = 26), intracranial internal carotid artery (n = 10), and middle cerebral artery branch (n = 3). Angioplasty achieved successful revascularization (Thrombolysis in Cerebral Ischemia grade 2b?3) in 76.9% of patients. Computed tomography angiography performed 7 days post-procedure revealed a maintained reperfusion in 82.8% of successful cases. Only two patients had symptomatic intracerebral hemorrhage. At the 3-month follow-up, 18 (48.6%) and 10 (27.0%) patients showed good and poor functional outcomes, respectively (modified Rankin Scale scores, 0?2 and 5?6).
Conclusion: Emergent balloon angioplasty and bailout self-expandable stent placement may be safe and effective for achieving successful revascularization in acute large vessel occlusion of the anterior circulation. It could be a feasible rescue method as well as a primary method for ERT.
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KEYWORD
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Stroke, Reperfusion, Stents, Angioplasty
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