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Updated: Jun 22, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
[Endovascular therapy of stenotic cerebral arteries]
Dagmar Krajícková1, Antonín Krajina, Miroslav Lojík
1Univerzita Karlova v Praze, Lékarská fakulta v Hradci Králové a Fakultní nemocnice v Hradci Králové, Neurologická klinika. krajickova@fnhk.cz
Insights
Endovascular surgery, including carotid angioplasty, offers a promising treatment for arterial occlusive diseases. This study found excellent results with a low restenosis rate and zero mortality in treated patients.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Neurology
Background:
- Endovascular surgery has revolutionized the treatment of occlusive arterial diseases.
- Balloon dilatation for internal carotid artery stenosis has been performed for two decades.
- This study evaluates outcomes of carotid angioplasty in specific patient groups.
Purpose of the Study:
- To assess the efficacy and safety of endovascular treatment for internal carotid artery stenosis.
- To analyze outcomes in patients unsuitable for conventional surgery, those with contralateral occlusion, and post-endarterectomy restenosis.
- To report on the restenosis and mortality rates of carotid angioplasty.
Main Methods:
- Retrospective analysis of 41 carotid angioplasties performed between January 1997 and June 2002.
- Inclusion of patients with vertebral artery stenosis, intracranial internal carotid artery stenosis, basilar artery stenosis, extracranial internal carotid stenosis with contralateral occlusion, restenosis post-endarterectomy, fibromuscular dysplasia, and contraindications to surgery.
- Data collection on restenosis and mortality.
Main Results:
- Excellent treatment outcomes were observed.
- Only three patients (7.5%) experienced restenosis.
- The mortality rate in this series was 0%.
Conclusions:
- Carotid angioplasty demonstrates excellent short-term results with low restenosis and no mortality in this patient cohort.
- Further randomized studies are necessary to compare outcomes and safety with surgical endarterectomy.
- Endovascular approaches offer a viable alternative for selected patients with carotid artery disease.
Abstract:
Endovascular surgery has dramatically changed the possibilities for treatment of occlusive arterial diseases. The first reports on balloon dilatation of internal carotid artery stenosis appeared 20 years ago. Between January 1997 and June 2002 37 patients were treated at our institution and 41 carotid angioplasties were performed. The first group includes the patients who were not indicated for conventional surgical treatment (vertebral artery 6 patients, intracranial stenosis of internal carotid artery 2 patients and one patient with stenosis of midle part of basilar artery). The second group were the patients with extracranial internal carotid stenosis combined with contralateral carotid occlusion (13 patients). The third group were the patients with restenosis following surgical carotid endarterectomy (11 patients). One patient had fibromuscular dysplastic stenosis. Seven patients were contraindicated for conventional surgical endarterectomy either for cardiopulmonary or other reasons. The result of the treatment by angioplasty was excellent because only three patients had restenosis (7,5%). Mortality rate in our set was 0. Nowadays it is too early to say if outcomes and safety of carotid angioplasty are comparable with surgical endarterectomy. For this reason it is necessary to have many randomized studies.
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