Percutaneous Transluminal Angioplasty of the Symptomatic Atherosclerotic Carotid Arteries

• DOI: 10.1161/01.str.27.12.2271
• Publication Date: 2011-06-17T20:10:52Z
• Authors: Alberto Gil-Peralta; Antonio Mayol; Jose R. Gonzalez ...; Alejandro Gonzalez; Jose Ruano; Fernando Boza; Fernando Duran
• Keywords: Male; Arteriosclerosis; Middle Aged; Survival Analysis; Syncope; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Ischemic Attack, Transient; Bradycardia; Humans; Carotid Stenosis; Female; Life Tables; Prospective Studies; Angioplasty, Balloon, Coronary; Hypotension; Aged; Cerebral Hemorrhage; Follow-Up Studies

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.