Treatment of Restenosis after PTA for Internal Carotid Stenosis

Abstract

Thirteen cases of restenosis occurred after percutaneous transluminal angioplasty (PTA) in 63 cases of internal carotid stenoses. They were treated by PTA or carotid endarterectomy. The patients were sufficiently informed of each treatment. Seven of them were initially treated by repeated PTA. The stenosis ratio improved from 82% to 30% after repeated PTA on average. However, one case in the PTA treated group resulted in restenosis and then carotid endarterectomy was performed. The other case also caused restenosis and was treated by PTA. Six cases were initially treated by carotid endarterectomy and all cases were successfully treated without difficulty. The success rate of the PTA was 2/7 (29%) in restenosis cases. One case causing re-restenosis had severe calcification in the arterial wall. PTA was thought to be effective for the restenosis cases after initial PTA if the arterial calcification was not severe.

Keywords

restenosis internal carotid artery PTA

Get full access to this article

View all access options for this article.

References

Mullan

Duda

Petronas

: Some examples of balloon technology in neurosurgery. J Neurosurg 52: 321–329, 1980.

Kerber

Cromwell

Loehden

: Catheter dilatation of proximal stenosis during distal bifurcation endarterectomy. Am J Neuroradiol 1: 348–349, 1980.

Bockenheimer

Mathias

: Percutaneous transluminal angioplasty in arteriosclerotic internal carotid artery stenosis. Am J Neuroradiol 4: 791–792, 1983.

Wiggli

Gratzi

: Transluminal angioplasty of stenotic carotid arteries: Case reports and protocol. Am J Neuroradiol 4: 793–795, 1983.

Tsai

Matovich

: Percutaneous transluminal angioplasty of the carotid artery. Am J Neuroradiol 7: 349–358, 1986.

Freitag

Koch

Wagemann

: Percutaneous angioplasty of carotid artery stenosis. Neuroradiology 28: 126–127, 1986.

Kachel

Endert

: Percutaneous transluminal angioplasty (dilatation) of carotid, vertebral, and innominate artery stenoses. Cardiovasc Intervent Radiol 10: 142–146, 1987.

Gil-Peralta

Mayol

: Percutaneous transluminal angioplasty of the symptomatic atherosclerotic carotid arteries, results, complications, and follow-up. Stroke 27: 2271–2273, 1996.

Theron

Payelle

: Carotid artery stenosis: Treatment with protected balloon angioplasty and stent placement. Radiology 201: 627–636, 1996.

10.

Yadav

Roubin

: Elective stenting of the extracranial carotid arteries. Circulation 95: 376, 1997.

11.

North American Symptomatic Carotid Endarterectomy Trial Collaborators : Beneficial effect of carotid endarterectomy in symptomatic patients with high grade stenosis. New Engl J Med 325: 445, 1991.

12.

Executive Committee for the Asymptomatic Carotid Atherosclerosis Study : Endarterectomy for asymptomatic carotid artery stenosis. JAMA 273: 1421, 1995.