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- Title
Efficacy of medical treatment and balloon angioplasty for severe intracranial atherosclerosis: a high-resolution MR vessel wall imaging.
- Authors
Huang, Juan; Jiao, Sheng; Chen, Yuhui; Lu, Jun; Song, Yan; Zhang, Jintao; Zhang, Chen; Liu, Cong; Gong, Tao; Wang, Daming; Zhu, Jinxia; Chen, Min
- Abstract
Objectives: To investigate the efficacy of medical treatment and balloon angioplasty for intracranial atherosclerosis using high-resolution MR vessel wall imaging (HR-MRI). Methods: In this prospective study, patients with symptomatic severe stenosis from January 2018 to August 2021 were treated with medical treatment or balloon angioplasty. The patients underwent HR-MRI at baseline and at 3, 6, and 12 months. Plaque characteristics at follow-up were compared with those at baseline using paired sample T-test or Wilcoxon rank sum test. The difference in the recurrence of ischemic events between two groups was compared. Results: A total of 37 patients (26 males; mean age = 60.5 ± 11.6 years) were evaluated. Of 68 plaques, 42 (61.8%) were treated with medication only. At 12 months of medical treatment, maximum plaque length (p = 0.004), maximum wall thickness (p = 0.036), and plaque enhancement (p = 0.001) were significantly reduced than baseline. At 3 months after balloon angioplasty, luminal stenosis (p = 0.048) was significantly reduced compared to baseline. At 6 months after balloon angioplasty, maximum plaque length (p = 0.011), maximum wall thickness (p = 0.003), and luminal stenosis (p = 0.001) were significantly reduced than baseline. No difference was found in the recurrence of ischemic events between two groups (p = 0.458). Conclusion: Intracranial atherosclerotic plaque shrank and tended to be stable at 12 months of medical treatment. Plaque burden was significantly reduced 6 months after balloon angioplasty. This may provide evidence for the application and selection of treatment strategies for intracranial atherosclerotic disease. Key Points: • Plaque burden and plaque enhancement were significantly reduced at 12 months of medical treatment compared to baseline. • Plaque burden was significantly reduced at 6 months after balloon angioplasty compared with baseline. • No significant difference in the recurrence rate of ischemic stroke between patients treated with medication and balloon angioplasty.
- Subjects
ATHEROSCLEROSIS treatment; TRANSLUMINAL angioplasty; MAGNETIC resonance imaging; STENOSIS; WILCOXON signed-rank test
- Publication
European Radiology, 2023, Vol 33, Issue 4, p2478
- ISSN
0938-7994
- Publication type
Article
- DOI
10.1007/s00330-022-09218-z