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Updated: Aug 8, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
[Interventional treatment for occlusive lesions in supra-arch vessels with brain ischemic symptoms]
Xiao-bo Zhang1, Zheng-yu Jin, Ning Yang
1Department of Radiology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.
Insights
Percutaneous transluminal angioplasty and stenting effectively treated supra-arch vessel occlusions causing brain ischemia. This safe procedure improved symptoms with low complication rates.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Neurology
Context:
- Occlusive lesions in supra-arch vessels (innominate, subclavian, internal carotid arteries) frequently cause cerebral ischemic symptoms.
- Severe stenosis (>60%) in these arteries poses a significant risk for stroke and neurological deficits.
Purpose:
- To evaluate the therapeutic efficacy and safety of percutaneous transluminal angioplasty (PTA) and stenting for treating occlusive lesions in supra-arch vessels.
- To assess the technical success, clinical outcomes, and complication rates associated with this endovascular intervention.
Summary:
- 56 lesions in 52 patients with >60% stenosis and ischemic symptoms underwent PTA and stenting.
- Technical success was 96.4%, with all patients showing symptom improvement and <30% residual stenosis.
- Complications were low (5.8%), with no 30-day mortality or major stroke during a 24-month follow-up.
Impact:
- PTA with or without stenting is a safe and effective treatment option for supra-arch vessel occlusive disease.
- This minimally invasive approach offers significant clinical benefit for patients experiencing cerebral ischemia due to these lesions.
- The procedure demonstrates a favorable safety profile, supporting its consideration in clinical practice.
Objective:
To evaluate the therapeutic effect of percutaneous transluminal angioplasty and stenting for occlusive lesions in supra-arch vessels with brain ischemic symptoms.
Methods:
A total of 56 occlusive lesions of the innominate, subclavian, and internal carotid arteries were treated with angioplasty and intravascular stent placement in 52 patients. The degree of stenosis was more than 60% in all patients and the leading symptom was brain ischemia. In 11 patients, the occluded subclavian artery could not be crossed via the femoral route, therefore the brachial route was used and the occlusion was crossed in a retrograde fashion.
Results:
Technical success was achieved in 54 of 56 procedures (96.4%). Residual stenosis was less than 30% in all cases. The clinical symptoms improved after procedure in all patients. Complications occurred in 3 of 52 (5.8%) procedures, and the 30-day mortality rate was 0. There were no death and severe stroke in the follow-up period (means 24 months). Restenosis was observed in 2 patients after percutaneous transluminal angioplasty treatment.
Conclusion:
Percutaneous transluminal angioplasty with or without stenting is a safe and valid choice for treatment of occlusive lesions of supra-arch vessels in patients with cerebral ischemic symptoms.
