중대뇌동맥 협착증에 대한 스텐트를 이용한 혈관성형술 후 호전된 뇌관류

Abstract

Recent advances in stent technology have allowed the introduction of more flexible stents that may be tracked more easily in the intracranial vessels. We present a patient with improved cerebral perfusion as assessed by single-photon emission computed tomographic(SPECT) scan after stent-assisted angioplasty for symptomatic middle cerebral artery stenosis. A 72-year-old man presented with multiple episodes of transient verbral disturbance and right-sided motor weakness for 5 months despite treatment with aspirin and clopedigrel. Angiography revealed a 50% to 60% stenosis of the left middle cerebral artery. 99m Tc-exametazime-SPECT scan demonstrated decreased cerebral blood flow in the left cerebral hemisphere, particularly in the left middle cerebral artery territory. The patient was recommended a stent-assisted angioplasty for middle cerebral artery stenosis. The patient underwent uncomplicated stenting with S-660 2.5- by 9-mm stent(Arterial Vascular Engineering, Santa Rosa, CA) of the left middle cerebral artery, with excellent angiographic results. Follow-up brain SPECT scan showed markedly improved perfusion. Stent-assisted percutaneous transluminal angioplasty can provide a favorable clinical course as well as improved cerebral perfusion for a patient with middle cerebral artery stenosis. Long-term follow-up data and additional clinical experience are required to assess the durability of this procedure.