Percutaneous transluminal angioplasty of the symptomatic atherosclerotic carotid arteries. Results, complications, and follow-up.
OBJECTIVE
Carotid endarterectomy reduces stroke risk in patients with > 70% symptomatic stenosis. We present our results of percutaneous transluminal angioplasty (PTA) as an alternative treatment.


METHODS
Ninety-eight patients with symptomatic > 70% stenosis of the internal carotid artery were considered for PTA. Details of the procedure, complications, and 4-year follow-up were registered.


RESULTS
Eighty-five PTAs were performed in a 4-year period. Transient cardiovascular effects were frequent: hypotension (54.1%), bradycardia (67.1%), asystole (25.9%), and syncope (16.5%). Transient ischemic attack occurred in 3 of 82 patients (3.7%), and disabling stroke occurred in 4 (4.9%); mortality was 0%. After a mean follow-up period of 18.7 months, 4 patients died, 1 due to fatal stroke. The overall probability of surviving any stroke or death was 86.7%. Restenosis (> 70%) was seen in 6 cases (7.4%).


CONCLUSIONS
PTA may be a reasonable treatment for symptomatic atherosclerotic stenosis, at least in patients at high risk for carotid endarterectomy.
Gil-Peralta
A
A
Department of Neurology, Hospital Universitario Virgen del Rocio, Seville, Spain.
Mayol
A
A
Marcos
J R
JR
Gonzalez
A
A
Ruano
J
J
Boza
F
F
Duran
F
F
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000401:mortality; D001161:Arteriosclerosis / Q000150:complications / Q000628:therapy*; D001919:Bradycardia / Q000453:epidemiology / Q000209:etiology; D016893:Carotid Stenosis / Q000150:complications / Q000628:therapy*; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007022:Hypotension / Q000453:epidemiology / Q000209:etiology; D002546:Ischemic Attack, Transient / Q000453:epidemiology / Q000209:etiology; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016019:Survival Analysis; D013575:Syncope / Q000453:epidemiology / Q000209:etiology