Tissue Kallikrein Preventing the Restenosis After Stenting of Symptomatic MCA Atherosclerotic Stenosis
Tissue Kallikrein Preventing the Restenosis After Stenting of Symptomatic MCA Atherosclerotic Stenosis
The study aims to determine whether tissue kallikrein (TK) is efficacy for preventing the
 long-term in-stent restenosis (ISR) after stenting of symptomatic atherosclerotic stenosis of
 the middle cerebral artery (MCA) M1 segment
A series of studies have confirmed the kallikrein-kinin system (KKS), including kallikrein,
 kininogen and kinin, plays an important role in the regulation of inflammation secondary to
 acute and chronic ischemic brain injury. Some researchers found that hTK gene delivery can
 inhibit the formation of neointimal induced by the common carotid artery ligation in mice.
 Further study revealed hTK gene transfection in VSMC lead to increased secretion of TK and
 inhibition of VSMC proliferation. In addition, it was also observed that the serum TK levels
 were coincident with the carotid artery stenosis. The more severe the stenosis is, the higher
 the serum TK level is, and the serum TK decreased after carotid artery angioplasty and stent
 placement. These results suggest that KKS play an important regulatory role in vascular
 remodeling and TK may exert a beneficial influence in the process of ISR
Inclusion Criteria:

 1. TIA or stroke in the MCA territory refractory to aggressive anti-platelet and regular
 statin therapy in 3 months

 2. Symptomatic MCA M1 segment stenosis ≥ 70% confirmed with DSA

 3. Successfully treated with PTAS without acute surgical complications in 12 hours after
 operation

 4. All patients provided fully informed consent

 Exclusion Criteria:

 1. Using angiotensin-converting enzyme inhibitors

 2. Severe cardiopulmonary dysfunction, chronic liver disease (A / G inversion, ALT
 increased 2-fold greater than normal), abnormal renal function (serum creatinine
 greater than 1.5 times normal)

 3. Allergies, the history of allergy to multi-drug

 4. The history of cerebral hemorrhage, brain tumors, brain trauma, cerebral embolism and
 other brain lesions

 5. During pregnancy or breast-feeding

 6. Not expected to complete follow-up