Preliminary outcomes of endovascular treatment of moyamoya disease

Purpose: This study aimed to investigate the effectiveness and safety of endovascular revascularisation of intracranial artery occlusion and stenosis in moyamoya disease using stent angioplasty. Materials and methods: We recruited 12 patients (8 women and 4 men) with occlusion and stenosis of intracranial arteries in the context of moyamoya disease who underwent endovascular stent angioplasty. Clinical data, baseline conditions, lesion location, treatment outcomes, periprocedural complications, and follow-up outcomes were analysed. Results: The occlusion was located at the M1 segment of the middle cerebral artery in 8 patients, at both the M1 and A2 segments in one patient, and at the C7 segment of the internal carotid artery in 3. Thirteen stents were deployed at the occlusion site, including the low-profile visualized intraluminal support (LVIS) device in 8 patients, an LVIS device and a Solitaire AB stent in one, and a Leo stent in 3, with a success rate of 100% and no intraprocedural complications. Plain CT imaging after stenting revealed leakage of contrast agent, which disappeared on the second day, resulting in no clinical symptoms or neurological sequelae. Follow-up angiography studies were performed in all patients for 6–12 months (mean, 8.8). Slight asymptomatic in-stent stenosis was observed in 2 patients (16.7%), and no neurological deficits were observed in the other patients. All preoperative ischaemic symptoms completely disappeared at follow-up. Conclusion: Stent angioplasty is a safe and effective treatment for occlusion and stenosis of intracranial arteries in moyamoya disease. Resumen: Objetivos: Evaluamos la eficacia y la seguridad de la revascularización endovascular de oclusiones y estenosis de arterias intracraneales mediante angioplastia con stent en pacientes con enfermedad de moyamoya. Materiales y métodos: Incluimos a 12 pacientes (8 mujeres y 4 hombres) con oclusiones y estenosis de arterias intracraneales en el contexto de enfermedad de moyamoya que se sometieron a angioplastia con stent. Recogimos datos clínicos e información sobre enfermedades existentes, localización de la lesión, resultados terapéuticos, complicaciones periprocedimiento y resultados de seguimiento. Resultados: La oclusión afectaba al segmento M1 de la arteria cerebral media en 8 pacientes, a los segmentos M1 y A2 en un paciente, y al segmento C7 de la arteria carótida interna en los 3 restantes. Se colocaron 13 stents en el lugar de la oclusión: stents LVIS