The Safety And Efficacy Of The Neuroform EZ Stent For The Treatment Of Symptomatic Atherosclerotic Stenosis In The Middle Cerebral Artery

Objective: To evaluate the safety and efficacy of Neuroform EZ stent placement for patients with symptomatic atherosclerotic stenosis of the middle cerebral artery（MCA）.To investigate the influence of related factors on restenosis after middle cerebral artery stenting.Methods:A retrospective analysis was performed on 79 patients with symptomatic MCA stenosis who received Neuroform EZ stenting between January 2018 and March 2021.The information of gender,age,length of vascular stenosis,residual stenosis rate and blood biochemical indexes were collected.The incidence of perioperative complications and clinical follow-up within 1 year were observed.The patients were followed up by telephone follow-up and outpatient follow-up.DSA or CTA follow-up was performed to observe whether patients had in-stent restenosis.SPSS 23.0 statistical software was used for analysis.T-test,rank-sum test and Chi-square test were used to compare the data between groups.After controlling relevant confounding factors,logistic regression model was used to analyze the factors related to in-stent restenosis.Results: The success rate of 79 patients was 100%.During the follow-up period after stent implantation,perioperative complications occurred in 4 cases（5.1%）,and 1 case was stent thrombosis.1 case was perforator artery obstruction.Two cases were transitional perfusion syndrome,and one of them had cerebral hemorrhage due to transitional perfusion.Within 1 year,the mortality rate and the incidence of distal vascular embolism were 0%.The incidence of intracerebral hemorrhage was 1.3% in perioperative period.The recurrence rate of stroke was 2.5%,all of which occurred in perioperative period.Of the 45 patients who underwent DSA or CTA,7（15.6%）were found to have stent restenosis,and none of the 7 patients had recurrent ischemic stroke.The stenosis length（P=0.029）and residual stenosis rate（P=0.039）synergically promoted the occurrence of in-stent restenosis.Conclusion: Our analysis indicates that the Neuroform EZ stent represents a valuable endovascular treatment option for patients with severe stenosis of the MCA.Excessive length of stenosis and high residual stenosis rate are the related factors of restenosis in stents.