Abstract
Carotid percutaneous transluminal angioplasty, with or without stent implantation, is becoming another therapeutic option for carotid revascularization. To evaluate the feasibility and effectiveness of the technique, from October of 1995 to March of 1997, we performed 24 percutaneous transluminal angioplasty procedures in 22 patients with severe extracranial carotid artery stenosis. Three common carotid and 21 internal carotid arteries were treated, and 19 procedures included stent implantation using nonarticulated PALMAZ stents (P154 and P204). Twelve patients were asymptomatic and 10 patients were symptomatic; 2 of the symptomatic patients had complete obstruction of the internal carotid artery that was successfully recanalized. Technical and angiographic success was achieved in 23 of 24 procedures, with the carotid artery obstruction diminishing from 85.6% +/- 8.5% to 5.7% +/- 3.2% (P < 0.001). Average stenosis length was 12.5 +/- 3.1 mm, and mean time of carotid occlusion during balloon inflation was 11.5 +/- 2.5 seconds. Three patients experienced transitory seizures during the procedure prior to dilation, 1 patient had a minor stroke with complete recovery within 72 hours, and 1 patient had a major stroke and died 45 days after the procedure. Clinical follow-up was achieved in all patients (mean, 10.5 +/- 7.2 months) and angiographic follow-up in 16 patients (mean, 6.3 +/- 1.2 months). The results obtained in this initial experience provide adequate support to continue further evaluation of this new therapeutic strategy.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Detre K., Holubkov R., Kelsey S., Cowley M., Kent K., Williams D., Myler R., Faxon D., Holmes D., Jr, Bourassa M. Percutaneous transluminal coronary angioplasty in 1985-1986 and 1977-1981. The National Heart, Lung, and Blood Institute Registry. N Engl J Med. 1988 Feb 4;318(5):265–270. doi: 10.1056/NEJM198802043180501. [DOI] [PubMed] [Google Scholar]
- Diethrich E. B., Gordon M. H., Lopez-Galarza L. A., Rodriguez-Lopez J. A., Casses F. Intraluminal Palmaz stent implantation for treatment of recurrent carotid artery occlusive disease: a plan for the future. J Interv Cardiol. 1995 Jun;8(3):213–218. doi: 10.1111/j.1540-8183.1995.tb00537.x. [DOI] [PubMed] [Google Scholar]
- Diethrich E. B. Indications for carotid artery stenting: a preview of the potential derived from early clinical experience. J Endovasc Surg. 1996 May;3(2):132–139. doi: 10.1177/152660289600300204. [DOI] [PubMed] [Google Scholar]
- Diethrich E. B., Ndiaye M., Reid D. B. Stenting in the carotid artery: initial experience in 110 patients. J Endovasc Surg. 1996 Feb;3(1):42–62. doi: 10.1583/1074-6218(1996)003<0042:SITCAI>2.0.CO;2. [DOI] [PubMed] [Google Scholar]
- Ferguson J. J. American College of Cardiology 45th Annual Scientific Session, Orlando, Florida, March 24 to 27, 1996. Circulation. 1996 Jul 1;94(1):1–5. doi: 10.1161/01.cir.94.1.1. [DOI] [PubMed] [Google Scholar]
- Grüntzig A. R., Senning A., Siegenthaler W. E. Nonoperative dilatation of coronary-artery stenosis: percutaneous transluminal coronary angioplasty. N Engl J Med. 1979 Jul 12;301(2):61–68. doi: 10.1056/NEJM197907123010201. [DOI] [PubMed] [Google Scholar]
- Kachel R., Basche S., Heerklotz I., Grossmann K., Endler S. Percutaneous transluminal angioplasty (PTA) of supra-aortic arteries especially the internal carotid artery. Neuroradiology. 1991;33(3):191–194. doi: 10.1007/BF00588215. [DOI] [PubMed] [Google Scholar]
- Mathur A., Dorros G., Iyer S. S., Vitek J. J., Yadav S. S., Roubin G. S. Palmaz stent compression in patients following carotid artery stenting. Cathet Cardiovasc Diagn. 1997 Jun;41(2):137–140. doi: 10.1002/(sici)1097-0304(199706)41:2<137::aid-ccd7>3.0.co;2-8. [DOI] [PubMed] [Google Scholar]