Percutaneous angioplasty of carotid artery stenoses

Abstract

Percutaneous angioplasty is a well-established method of treating arterial stenoses and occlusions in various regions. In the carotid area this technique is still under discussion. The successful application of angioplasty in eight patients with carotid artery stenoses is reported.

Safety and Efficacy of Endovascular Treatment of Carotid Artery Stenosis Compared With Carotid Endarterectomy

“…We identified reports of Ͼ5000 carotid angioplasty and stenting procedures while identifying studies for this review. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] The 30-day risk of stroke or death from these reports ranged from 2% to 9%, with an average rate of 4.7%. Thus, the complication rate for endovascular treatment from case series data are Ͻ30-day complication rate for surgery reported in ECST (stroke rate 7.5%), 1 similar to that in NASCET (stroke rate 5.5%) 2 but greater than in the asymptomatic carotid atherosclerosis study (stroke or death rate 2.3%) 3 or the asymptomatic carotid surgery trial (stroke or death rate 3.1%).…”

“…[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] The advantages to treating carotid stenosis in this way include avoidance of general anesthesia and its complications such as myocardial infarction and pulmonary embolism. Endovascular treatment is usually performed via a femoral catheter, thus avoiding an incision in the neck and subsequent cranial and cutaneous nerve damage.…”

Angioplasty of the Internal Carotid Artery: Results, Complications and FoIlow-Up in 61 Cases

“…However, the fundamental question remains unan swered: can PTA produce a beneficial clinical effect simi lar to CEA? In our opinion, the available data [22][23][24][25][26][27][28][29][30][31] justify the initiation o f a randomized trial in order to answer this question. However, the controversy remains as to whether PTA has achieved a sufficient technical standard to merit a comparative trial.…”

“…O ur preliminary data, and those published by other groups, support this argument. Data on neurological complications resulting from PTA, gathered from published PTA scries, are sum marized in table 2 [22][23][24][25][26][27][28][29][30][31]. Pooled data show the risk of disabling stroke to be 2.5% and the risk o f any stroke to be 3.7%.…”

Society of Interventional Radiology

“…However, it must be remembered that the condition being treated is usually not emergent, and therefore transfer to a facility with the skills, training, and knowledge to perform this procedure with acceptable quality assurance is almost always possible. There are several preliminary single-center experiences that have been published as well as an international multicenter compilation (61)(62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74)(75)(76)(77)(78)(79). Four randomized, controlled trials for evaluation of this technology have been completed and reported.…”