The Endovascular Treatment of Carotid and Vertebral Artery Atherosclerotic Disease
The treatment of arterial stenosis by endovascular techniques has the attraction of avoiding open surgery and general anaesthesia which are required for endarterec-tomy or bypass surgery. Percutaneous transluminal angioplasty (PTA) is frequently performed and is often the first line procedure for stenosis of the peripheral and coronary vessel. There has been reluctance to recommend PTA for the cerebral circulation because of the anxiety about the risks of cerebral embolism (Health and Public Policy Committee, 1983). However, evidence is accumulating that the risks of PTA in the proximal internal carotid and vertebral arteries are no greater than those of PTA at other sites and are similar to the risks of carotid surgery. Clinical trials are now underway assess the procedure and to compare it with carotid endarterectomy, in particular the Carotid Vertebral Artery Transluminal Angioplasty Study. It is possible that if these confirm the safety and efficacy of cerebral vascular PTA, the procedure will become the preferred alternative to surgery in suitable patients. Cerebral vascular PTA also provides a valuable option in experienced centres for the treatment of patients with surgically inaccessible vertebral carotid artery stenosis or for patients who are not fit for surgery.
KeywordsCholesterol Catheter Dioxide Pneumonia Aspirin
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