Follow-up Study after Percutaneous Transluminal Cerebral Angioplasty

Abstract

The purpose of this study was to assess the safety and efficacy of percutaneous transluminal cerebral balloon angioplasty (PTCBA) of extra- and intra-cranial arteries by investigating procedural outcome. Eighty haemodynamically significant extra- and intra-cranial lesions (% diameter stenosis >70) in 74 clinically symptomatic patients were treated by elective and initial PTCBA between March 1991 and February 1996 and followed thereafter.

Death, stroke including transient ischemia, surgery, or repeated angioplasty of restenosis or new lesions were regarded as cerebral events after the initial PTCBA. Crescendo ischaemic symptoms disappeared completely after clinically successful dilatation. The clinical success rate was 81% (65/80). Angiographic restenosis rate at 3 months was 22% (14/65).

By life-table method, the death/stroke risk was 16% and death/stroke/surgery/repeated PTCBA risk was 49 % at 2 years following PTCBA, respectively.

In conclusion, PTCBA successfully, decreased recurrent neurological symptoms and produced a favourable short-term outcome, whereas restenosis limited long-term benefit.

Keywords

extracranial artery intracranial artery angioplasty outcome

Get full access to this article

View all access options for this article.

References

Higashida

Tsai

: Percutaneous transluminal angioplasty of extra- and intracranial cerebral vascular disease. Neuroradiology 37 (suppl): 449–450, 1995.

Clark

Barnwell

: Safety and efficacy of percutaneous transluminal angioplasty for intracranial atherosclerotic stenosis. Stroke 26: 1200–1204, 1995.

Mori

Fukuoka

Mori

: Percutaneous transluminal angioplasty for arteriosclerotic lesions of extra- and intracranial arteries. Neuroradiology 37: (suppl), 451–452, 1995.

Ferguson

RDG

Ferguson

: Carotid angioplasty. In search of a worthy alternative to endarterectomy. Arch Neurol 53: 696–698, 1996.

Vorstrup

Brun

Lassen

: Evaluation of the cerebral vasodilatory capacity by the acetazolamide test before EC-IC bypass surgery in patients with occlusion of the internal carotid artery. Stroke 17: 1291–1298, 1986.

Touho

: Percutaneous transluminal angioplasty in the treatment of atherosclerotic disease of the anterior cerebral circulation and haemodynamic evaluation. J Neurosurg 82: 953–960, 1995.

North America Symptomatic Carotid Endarterectomy Trial Collaborators : Beneficial effect of carotid endarterectomy in symptomatic patients with high- grade carotid stenosis. N Engl J Med 325: 445–453, 1991.

Mori

: Serial angiographic follow-up after percutaneous transluminal cerebral angioplasty. Neuroradiology 39: 111–116, 1997.

Theron

Courtheoux

: New triple coaxial catheter system for carotid angioplasty with cerebral protection. Am J Neuroradiol 11: 869–874, 1990.

10.

Serruys

Luiten

: Incidence of restenosis after successful coronary angioplasty: A time-related phenomenon. A quantitative angiographic study in 342 consecutive patients at 1,2,3, and 4 months. Circulation 77: 361–371, 1988.

11.

Mori

: Percutaneous transluminal cerebral angioplasty for total occlusion of middle cerebral arteries. Neuroradiology 39: 71–74, 1997.

12.

Honda

Mori

: Successful percutaneous transluminal angioplasty of the intracranial vertebral artery 1 month after total occlusion. Neurol Med Chir 34: 551–554, 1994.

13.

Ferguson

Schwarten

: Restenosis following cerebral percutaneous transluminal angioplasty: The NACPTAR Investigators. Stroke 26: 186, 1995.

14.

Gruentzig

King

III : Long-term follow-up after percutaneous transluminal coronary angioplasty: The early Zurich experience. N Engl J Med 316: 1127–1132, 1987.

15.

Nobuyoshi

Kimura

: Restenosis after successful percutaneous transluminal coronary angioplasty: Serial Angiographic Follow-up of 229 patients. J Am Coll Cardiol 12: 616–623, 1988.

16.

Mori

: Follow-up study after percutaneous transluminal cerebral angioplasty. Eur Radiol 8: 403–408, 1998.

17.

Mori

Fukuoka

: Follow-up study after intracranial percutaneous transluminal cerebral angioplasty. Am J Neuroradiol 19: 1525–1533, 1998.