Mechanism of neurological deficit improvement through analysis in cerebral artery stenosis, Endothelial Progenitor Cells (EPC), Asymmetric Dimethylarginine (ADMA), Malondialdehyde (MDA), and Superoxide Dismutase (SOD) after balloon angioplasty procedure in ischemic stroke patients

Backgrounds: Balloon angioplasty is one of the endovascular procedures which aims to open atherosclerotic stenosis or occlusion of the cerebral blood vessels. Balloon angioplasty has been performed on ischemic stroke patients with arteriosclerotic stenosis. However, the procedure’s outcomes vary, and no microcellular indicator has become a standard for balloon angioplasty. Methods: NIHSS examination and Digital Subtraction Angiography (DSA) were performed on 35 ischemic stroke patients. NIHSS examination is used to determine the severity of neurological deficits. At the same time, Digital Subtraction Angiography (DSA) is a diagnostic procedure to determine the location and size of the stenotic lesion in the arteries. Patients underwent several laboratory biomarker analyses, including EPC, ADMA, MDA and SOD, followed by balloon angioplasty. Afterward, repeat the DSA procedure. EPC, ADMA, MDA and SOD were re-analysed seven days later and NIHSS was re-examined thirty days after balloon angioplasty. Results: Stenosis, EPC (p<0.001), MDA (p=0.001), SOD (p=0.001), and NIHSS (p<0.001) have significant output before and after balloon angioplasty (p<0.001). EPC and SOD significantly correlate with neurological deficits alteration (p<0.05). EPC and SOD have a cut-off value of 50% improvement in neurological deficits. EPC and SOD significantly improve neurological deficit (p=0.008 and p<0.001). Conclusion: The mechanism of neurological deficit improvement in balloon angioplasty procedure happened through the elevation of EPC and SOD levels. The outcomes of balloon angioplasty could be estimated by measuring the EPC and SOD values as the standard for indicators adjustment to measure clinical progress after balloon angioplasty in ischemic stroke patients.