Cervical carotid artery stenosis: which technique, balloon angioplasty or surgery?
METHODS
Between April 1991 and November 1995, 38 patients mean age 65 (6 females, 32 males) were treated by cervical puncture for isolated cervical carotid stenosis (33 internal, 1 external, and 6 common carotid). All patients but 5 were symtomatic (19 TIA, 7 amarosis, 2 strokes and 4 VB symptoms). Complex lesions involving the carotid bifurcation and heavy calcifications were treated by conventional surgery. Two different groups of patients were considered. A first group of 19 patients (17 restenosis, 1 primary, 1 FM dysplasia) was treated by simple balloon angioplasty (BA). A second group of 19 patients was treated by primary stenting (16 DF NOVO, 2 radio-induced, and 2 recurrent stenosis).


RESULTS
No hematoma required surgery. In the first group one patient died from an intracerebral hemorrhage, one presented a reversible stroke and 3 others a TIA. In the second group there was no complication or silent infarction on the CT SCAN:


CONCLUSIONS
Balloon angioplasty appears to be associated with a high neurologic risk. While primary stenting seems much more reliable. A longer follow-up to deal with restenosis. Conventional surgery remains the gold standard.
Bergeron
P
P
St. Joseph Hospital Foundation, Marseilles, France.
Chambran
P
P
Hartung
O
O
Bianca
S
S
D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects; D016893:Carotid Stenosis / Q000150:complications / Q000601:surgery / Q000628:therapy*; D002561:Cerebrovascular Disorders / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012008:Recurrence; D012307:Risk Factors; D015607:Stents