title: Endovascular therapy for stenosis of the petrous or cavernous portion of the internal carotid artery: percutaneous transluminal angioplasty compared with stent placement.
abstract: OBJECTIVE
  The effects of percutaneous transluminal angioplasty (PTA) and stent placement for stenosis of the petrous or cavernous portion of the internal carotid artery (ICA) were compared.
  
  
  METHODS
  Twenty-four patients with symptomatic, greater than 60% stenosis of the petrous or cavernous portion of the ICA were treated using PTA or stent placement; 15 were treated with PTA and nine with stent insertion. Initial and follow-up results (> 3 months posttreatment) were compared in each group. Stenotic portions of the ICA were successfully opened in 13 of 15 patients in the PTA group, and in all nine patients in the stent-treated group. In one case in the PTA group stent delivery was attempted; however, the device could not pass through the vessel's tortuous curve, and PTA alone was performed in this case. Postoperatively, the mean stenotic ratio decreased from 72.1 to 29.6% in the PTA group, and from 75.6 to 2.2% in the stent-treated group. In four patients in the PTA group, stenoses greater than 50% were demonstrated on follow-up angiography performed at 3 to 6 months after PTA. In the stent-treated group, no restenosis was encountered, although in one case acute occlusion of the stent occurred; the device was recanalized with PTA and infusion of tissue plasminogen activator. This case was the only one of the 24 in which any neurological deficits related to the endovascular procedure occurred. Stent placement brought a greater gain in diameter than did PTA at the initial and late follow-up period; this gain was statistically significant.
  
  
  CONCLUSIONS
  Stent placement is more effective than PTA for stenosis of the petrous or cavernous portion of the ICA from the viewpoint of initial and late gain in diameter.
authors.affiliation: Department of Neurological Surgery, Wakayama Medical University, Wakayama City, Japan. teradato@wakayama-med.ac.jp
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Terada
authors.forename: Mitsuharu
authors.initials: M
authors.lastname: Tsuura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Matsumoto
authors.forename: Osamu
authors.initials: O
authors.lastname: Masuo
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Tsumoto
authors.forename: Hiroo
authors.initials: H
authors.lastname: Yamaga
authors.forename: Toru
authors.initials: T
authors.lastname: Itakura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000592:standards*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D002533:Cerebral Angiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015607:Stents / Q000009:adverse effects / Q000592:standards*