Results of balloon angioplasty in the carotid arteries.
OBJECTIVE
To report the experiences to date with percutaneous transluminal angioplasty (PTA) of the carotid artery and other supra-aortic vessels. A new coaxial dilatation system for carotid angioplasty with temporary balloon occlusion to avoid cerebral embolization is presented.


METHODS
PTA was performed in 220 patients with 245 stenosed or occluded supra-aortic arteries; among these were 74 carotid stenoses in the proximal common (n = 5), distal common (n = 1), internal (n = 65), and external (n = 3) carotid arteries. Duplex and B-mode ultrasonography, computed tomography, magnetic resonance imaging, single-photon emission computed tomography, indium 111-labeled platelet scintigraphy, and/or angiography were used before and after PTA. Intravascular ultrasound imaging was also recently added for monitoring angioplasty results.


RESULTS
All patients but one with carotid lesions had symptoms of cerebrovascular insufficiency. Angioplasty was successful in 69 of the 74 carotid stenoses: proximal common (n = 5), distal common (n = 1), internal (n = 60), and external (n = 3). There were only 1 major (hemiparesis) and 2 minor complications. During the average 70-month observation period, restenosis has not occurred in any treated carotid artery. In a literature review of > 500 patients undergoing carotid angioplasty, the complication rate appears very low (mortality 0%; morbidity 2.1%) and comparable to that for carotid endarterectomy.


CONCLUSIONS
Results of this review suggest that percutaneous transluminal angioplasty of the carotid artery is an effective alternative method to vascular surgery, particularly for patients with comorbidities that elevate the risks of surgery.
Kachel
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Department of MRI and Neuroradiology, Institute of Diagnostic Radiology, Medical School Erfurt, Germany.
D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000379:methods; D002545:Brain Ischemia / Q000209:etiology; D017536:Carotid Artery, Common / Q000473:pathology; D002342:Carotid Artery, External / Q000473:pathology; D002343:Carotid Artery, Internal / Q000473:pathology; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D002533:Cerebral Angiography; D016894:Endarterectomy, Carotid; D005260:Female; D006429:Hemiplegia / Q000209:etiology; D006801:Humans; D007205:Indium Radioisotopes; D002542:Intracranial Embolism and Thrombosis / Q000517:prevention & control; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D015996:Survival Rate; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D018616:Ultrasonography, Doppler, Duplex; D018084:Ultrasonography, Interventional
D007205:Indium Radioisotopes