796-1 Non Surgical Revascularization in Carotid Arteries: Role of Percutaneous Transluminal Angioplasty

The role of Percutaneous Transluminal Angioplasty (PTA) in the revascularization of carotid arteries is not well established. The aim of this study was to asses the efficacy of PTA in revascularizing patients with carotid arterial stenosis. Thirteen consecutive patients (mean age 68 ± 7.7 years) underwent 13 PTA procedures in the carotid arteries during September 1992 to March 1994. The indication for revascularization was recurrent ischemic attacks with severe (g50%) carotid stenosis in the 13 cases. Time between symptoms onset to PTA was more than one month in all cases. The lesions were located in the internal carotid arteries (first extracraneal segment) in nine patients and in the common carotid arteries in four. This group included one patient treated by severe internal carotid stenosis with complete occlussion in the contralateral internal carotid vessel. PTA was performed using conventional technique. The balloon/artery ratio was 0.8–0.9/1 in all cases (Mean balloon size 5.3 ± 0.5 mm). Results PTA was successfully performed in all patients with the diameter stenosis reduced from, 77.5 ± 5% to 19.7 ± 4%. Four patients had bradycardia and hypotension during balloon inflation. Two patients had transient neurologic deficit immediately after the procedure, resolved within 24 hours. No patient had a residual neurologic deficit upon discharge (mean 48 hours). At late clinical follow up (mean time 10 ± 7 months) one patient had restenosis with a new successful PTA. Conclusion This early experience showed that PTA can be performed successfully and safely in selected cases of patients with symptomatic severe stenosis in carotid arteries. However, larger groups of patients and longer follow-up should need to compare this technique with surgical-endarterectomy.