PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY OF THE SYMPTOMATIC ATHEROSCLEROTIC CAROTID ARTERIES - RESULTS, COMPLICATIONS, AND FOLLOW-UP

Background and Purpose Carotid endarterectomy reduces stroke risk in p atients with >70% symptomatic stenosis. We present our results of perc utaneous transluminal angioplasty (PTA) as an alternative treatment. M ethods Ninety-eight patients with symptomatic >70% stenosis of the int ernal 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%), asyst ole (25.9%), and syncope (16.5%). Transient ischemic attack occurred i n 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 pati ents 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 caroti d endarterectomy.