EXTRACRANIAL CAROTID ANGIOPLASTY AND STENTING - INITIAL RESULTS AND SHORT-TERM FOLLOW-UP

Carotid percutaneous transluminal angioplasty, with or without stent i mplantation, is becoming another therapeutic option for carotid revasc ularization. To evaluate the feasibility and effectiveness of the tech nique, from October of 1995 to March of 1997, we performed 24 percutan eous transluminal angioplasty procedures in 22 patients with severe ex tracranial carotid artery stenosis. Three common carotid and 21 intern al carotid arteries were treated, and 19 procedures included stent imp lantation using nonarticulated PALMAZ(R) stents (P154 and P204). Twelv e patients were asymptomatic and 10 patients were symptomatic; 2 of th e symptomatic patients had complete obstruction of the internal caroti d 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 caroti d occlusion during balloon inflation was 11.5 +/- 2.5 seconds. Three p atients experienced transitory seizures during the procedure prior to dilation, I patient had a minor stroke with complete recovery within 7 2 hours, and 1 patient had a major stroke and died 45 days after the p rocedure. 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 therapeut ic strategy.