PTA for Internal Carotid Artery Stenosis.
Thirty-one lesions of internal carotid artery (ICA) stenosis were treated by percutaneous transluminal angioplasty (PTA). All the patients were males except two. There were 18 extracranial ICA stenosis and 13 intracranial ICA stenosis. Four patients were treated in acute stage and 27 were in chronic stage. In 27 patients in the chronic stage, clinical presentation was transient ischemic attack or reversible ischemic neurological deficits or minor completed stroke. Dilatation of any degree was observed in all patients except one in the chronic group. Good dilatation (stenosis ratio after PTA is less than 50%) was observed in 11 out of 13 intracranial lesions and in 10 out of 14 extracranial lesions. Restenosis was two out of 11 intracranial good dilated lesions and 6 out of 10 good dilated extracraniallesions. No patients but one have experienced recurrent symptoms. Symptomatic complications occurred in only one patient who encountered arterial dissection during PTA resulting in severe hemiparesis. In four patients in the acute stage, dilatation of any degree was observed in two and good dilatation was seen in two. In conclusion, PTA for chronic ICA stenosis is an effective and safe technique. However, extracranial lesions tend to develop restenosis. Self-expandable stent will be one of the solutions for extracranial lesions. Major complications of PTA are distal embolism and arterial dissection. PTA for acute ICA stenosis is a challenging technique.
Ezura
M
M
Division of Intravascular Neurosurgery, Department of Neurosurgery, Kohnan Hospital; Sendai, Japan.
Takahashi
A
A
Fukuchi
M
M
Yoshimoto
T
T