Speakers

Middle meningeal artery embolization for chronic subdural hematoma
1108 13:40-13:50
Cerebrovascular/304B
Chronic subdural hematoma (CSDH) is the most common neurological pathology requiring neurosurgical management worldwide. The treatment strategies for CSDH include observation, medical treatment, and surgical removal of hematoma. Middle meningeal artery (MMA) embolization has emerged as an alternative or adjuvant treatment. Several studies had demonstrated convincing clinical and radiographic outcomes following MMA embolization for CSDH. Nonetheless, the embolization of MMA entails specific risks of procedure related complications, including vascular injuries, inadvertent occlusion of collateral arteries, visual complication and cranial nerve palsy. Herein, we reported the clinical and radiographic outcomes of MMA embolization with simple coiling, and compared the results with traditional surgical evacuation of CSDH. Simple coiling can be an alternative choice for liquid agents or particles in MMA embolization for CSDH with better safety.

Intracranial stenting for atherosclerotic stenosis
1108 16:40-16:50
Cerebrovascular/304B
Intracranial atherosclerosis disease (ICAD) accounts for nearly 10% of the stroke and transient ischemic attack (TIA) cases and up to 50% of cerebral vascular events in the Chinese population. Current treatment strategies for ICAD include medical treatment combined with aggressive lifestyle management and endovascular revascularization. Though the initial clinical trials did not show benefit of stenting compared with medical therapy, with improvements in endovascular technique, stenting had resurfaced after the WEAVE trial. With careful patient selection criteria and adequate surgeon experience, the periprocedural stroke and death rate were lower than expected (2.6%). Stenting has the potential to become one of the solutions for ICAD. In-stent restenosis (ISR) after stent placement has been an important factor in recurrent stroke. Though mostly asymptomatic, ISR can reach up to 30%, with an incidence that is much higher than expected. Post-dilation angioplasty had been used in stents for carotid artery and coronary artery in selected patients, but its effect on the wingspan system has yet to be found. Based on the result of our cinical study, the post-dilation method can be feasibly performed and can offer better stent expansion and apposition in the wingspan system. By applying this technique, we might prevent in-stent restenosis and improve neurological outcomes.