Percutaneous transluminal angioplasty in selected patients with severe carotid artery stenoses: the results of a consecutive series of 24 patients.

Objectives: To assess clinically and with duplex scanning the results of percutaneous transluminal angioplasty in a subgroup of patients with carotid artery stenosis.

Design: A retrospective study.

Materials: Twenty-four patients with focal hemispheric neurological symptoms from a concentric, smooth carotid stenosis more than 70% treated with balloon dilatation. Control investigations were performed with duplex scanning.

Results: Angiography after PTA revealed no residual stenosis in 15 patients (62%), a stenosis of less than 50 was seen in seven patients (30%) and PTA was ineffective in two patients (8%). Three patients (13%) had transient ischaemic attacks during the procedure but none had strokes. One patient experienced short lasting paraesthesia of the arm a few hours after the PTA procedure. After a follow-up of a mean of 11 months (1-38) no recurrent symptoms had occurred. Clinical success was thus achieved in 22 of 24 patients (92%). At duplex scanning, 16 (66%) patients had no stenosis, six patients (30%) had a stenosis of 70%, one patient (4%) a stenosis of 80%, and one patient had an occluded carotid artery.

Conclusion: Our results indicate that PTA in a selected group of patients with carotid artery stenosis is safe and the interim, long-term results are promising. The procedure must be evaluated in a randomised prospective study against surgical treatment.