A simple technique for minimising complications of percutaneous transluminal angioplasty for internal carotid stenosis

Abstract

The application of percuteneous transluminal angioplasty (PTA) to the treatment of cerebrovascular diseases risks complications caused by emboli flowing into the intracerebral arteries. We report here a simple technique to prevent such complications of PTA for internal carotid artery stenosis. The principle of the technique is to occlude the common carotid artery with a latex balloon mounted on a guiding catheter during the PTA procedures. This usually gives rise to retrograde flow from the internal carotid artery, which carries debris away to the external carotid artery. We treated 18 cases of internal carotid artery stenosis by this technique. It was confirmed before the PTA procedure that slow injection of contrast medium through the guiding catheter demonstrated retrograde flow from the internal carotid artery. Excellent results were obtained in all cases, without any complications. We found that the proximal occlusion technique was much easier to perform than the distal occluion technique. The present technique appears to offer a practical and useful procedure for treating internal carotid artery stenosis.