FEASIBILITY OF INTRAOPERATIVE BALLOON ANGIOPLASTY AND ADDITIONAL STENT PLACEMENT OF ISOLATED STENOSIS OF THE BRACHIOCEPHALIC TRUNK

Objective: We sought to evaluate the feasibility and results of intrao perative balloon angioplasty and additional stent placement of isolate d stenosis of the brachiocephalic trunk. Patients and methods: Between May 1993 and October 1996, we treated eight patients with local steno sis of the innominate artery. Seven lesions were situated in the proxi mal and one in the middle third of the brachiocephalic trunk, Five pat ients were men and three were women, with ages ranging from 55 to 72 y ears (mean 59.5 Sears), All stenoses provoked severe blood flow reduct ion and caused clinical symptoms. Procedures were performed in an oper ating suite with fluoroscopic imaging capabilities. Through an anterol ateral cervical approach the right common carotid artery was surgicall y exposed and then clamped to avoid atheroembolization during the subs equent procedure, Retrograde catheterization was performed to reach th e stenosis of the brachiocephalic trunk. The lesion was dilated with a balloon catheter and successively stented. Follow-up examinations (co lor-coded duplex sonography, accompanied by clinical inspection and sy stolic blood pressure) were scheduled every 6 months. Results: In all patients the dilation of the stenosis of the innominate artery and the stent placement were successful without any side effects. No embolic events or other complications occurred. The postintervention angiograp hy showed successfully dilated stenoses and patent stents in all cases . The technical success rate was 100%. Conclusions: On the basis of ou r preliminary data, we believe that, in selected patients, intraoperat ive balloon angioplasty of stenosis of the innominate artery with sten t placement from the right common carotid artery approach is a safe an d effective alternative to conventional operations.