Cervical carotid artery stenosis: which technique, balloon angioplasty or surgery?

J Cardiovasc Surg (Torino). 1996 Jun;37(3 Suppl 1):73-5.

Abstract

Methods: Between April 1991 and November 1995, 38 patients mean age 65 (6 females, 32 males) were treated by cervical puncture for isolated cervical carotid stenosis (33 internal, 1 external, and 6 common carotid). All patients but 5 were symtomatic (19 TIA, 7 amarosis, 2 strokes and 4 VB symptoms). Complex lesions involving the carotid bifurcation and heavy calcifications were treated by conventional surgery. Two different groups of patients were considered. A first group of 19 patients (17 restenosis, 1 primary, 1 FM dysplasia) was treated by simple balloon angioplasty (BA). A second group of 19 patients was treated by primary stenting (16 DF NOVO, 2 radio-induced, and 2 recurrent stenosis).

Results: No hematoma required surgery. In the first group one patient died from an intracerebral hemorrhage, one presented a reversible stroke and 3 others a TIA. In the second group there was no complication or silent infarction on the CT SCAN:

Conclusions: Balloon angioplasty appears to be associated with a high neurologic risk. While primary stenting seems much more reliable. A longer follow-up to deal with restenosis. Conventional surgery remains the gold standard.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Angioplasty, Balloon* / adverse effects
  • Carotid Stenosis / complications
  • Carotid Stenosis / surgery
  • Carotid Stenosis / therapy*
  • Cerebrovascular Disorders / etiology
  • Female
  • Humans
  • Male
  • Postoperative Complications
  • Recurrence
  • Risk Factors
  • Stents