ABSTRACT
One possible problem in internal carotid angioplasty is inaccessibility of the lesion due to elongation of the aortic arch, the brachiocephalic trunk, or the carotid artery itself. A new approach to performing angioplasty of the right or left internal carotid artery utilizing the brachial artery was used after failure of the transfemoral approach in 5 lesions (4 patients). The common carotid artery was cannulated with performed 5F catheters. Angioplasty was performed with a conventional balloon dilatation catheter. If required, a Wall stent was implanted to optimize the angiographic result. After failure of the conventional transfemoral technique, the brachial technique permitted successful angioplasty of the ipsilateral internal carotid artery in 4 lesions and the contralateral internal carotid artery in 1 lesion. In 1 patient, a stent was implanted. No complications occurred. The mean stenosis diameter decreased from 77.8 +/- 6.3% to 17.8 +/- 9.1%. Doppler sonography performed 4-6 months later showed no restenosis. The brachial artery approach seems to be a suitable alternative to the femoral technique.
Subject(s)
Angioplasty, Balloon/methods , Brachial Artery , Carotid Stenosis/therapy , Aged , Angioplasty, Balloon/instrumentation , Carotid Artery, Internal/diagnostic imaging , Carotid Stenosis/diagnostic imaging , Female , Follow-Up Studies , Humans , Male , Radiography , Ultrasonography, DopplerABSTRACT
An iliac aneurysm developed after local lysis and balloon dilatation of the left iliofemoral arteries in a 66-year old male patient. This led to arterial embolism. A self-expanding Dacron-Nitinol vascular endoprosthesis was inserted without surgery. In this way, the aneurysm was isolated from the circulation.