Complications of stenting for symptomatic middle cerebral artery stenosis and their rescue

Abstract

Intravascular stents are being used with increasing frequency in interventional neuroradiology. We present two cases of arterial rupture and subarachnoid hemorrhage during middle cerebral artery stenting. Extravasation of contrast material and massive subarachnoid hemorrhage during stenting in one case resulted in mortality. In the other case, overlapping stenting and balloon tamponade on the dissected vessel, however, were performed emergently. Thereafter, thrombotic occlusion of the middle cerebral artery was managed by intraarterial abciximab administration. Serial angiography showed that normal vessel patency was reestablished within 20 min. We discuss complications of stenting for symptomatic middle cerebral artery stenosis and their rescue work.