Percutaneous Transluminal Angioplasty of the Symptomatic Atherosclerotic Carotid Arteries

Abstract

Background and Purpose 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.