Endovascular treatment for internal carotid stenoses. long-term follow-up results and overall complications.
Seventy four cases of internal carotid stenoses greater than 60% were treated by PTA and/or stenting 86 times. Sixty one cases of cervical ICA stenosis were treated 71 times. 11 cases of high cervical - intracranial ICA stenosis were treated 13 times. Two cases of ICA dissection were treated by stent deployment. Stenotic ratio reduced from 79% to 29% in cervical ICA stenosis and 71 % to 32% in high cervical to intracranial ICA stenosis in average. Morbidity related to PTA and/or stenting was 2/74 (2.7%) and mortality was 0%. One was an ischemic complication and the other was a hemorrhagic complication due to hyperper fusion. Restenosis (stenosis greater than 70%) rate was 32%. Asymptomatic cerebral embolism were found in three cases (4.2%) on angiogram immediately after PTA and/or stenting. The complication rate related to PTA and/stenting was low but asymptomatic emboli were found in three cases. Considering these results, the indication for PTA and/stenting should be restricted to patients with high risk group, such as cases with high medical risks or difficult CEA cases, if appropriate protective systems for cerebral emboli were not available.
Terada
T
T
Department of Neurological Surgery, Wakayama Medical College, Hidaka General Hospital, Wakayama Red Cross Hospital, Wakayama City, Japan. teradato@wakayama-med.ac.jp.
Tsuura
M
M
Yokote
H
H
Matsumoto
H
H
Masuo
O
O
Nakai
K
K
Itakura
T
T
Yamaga
H
H
Moriwaki
H
H
Hyotani
G
G
Kamei
I
I