scholarly journals Angioplasty of an Idiopathic Intracranial Arterial Stenosis

2006 ◽  
Vol 12 (4) ◽  
pp. 307-311
Author(s):  
K.F. Layton ◽  
D.F. Kallmes ◽  
H.J. Cloft
Keyword(s):  
Medical Therapy ◽  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
Intracranial Stenosis ◽  
Arterial Stenosis ◽  
Pharmacologic Therapy ◽  
Presenting Symptoms ◽  
Atherosclerotic Stenosis ◽  
Percutaneous Transluminal ◽  
Multiple Episodes

Treatment of symptomatic intracranial atherosclerotic stenosis usually involves maximizing medical therapy. In patients with medically refractory symptoms despite maximum pharmacologic therapy, intracranial angioplasty and/or stenting has become an accepted treatment option. The use of percutaneous transluminal angioplasty (PTA) for idiopathic intracranial stenoses has not been reported to date. We describe a case of idiopathic intracranial stenosis which was refractory to medical therapy and was successfully treated with percutaneous transluminal angioplasty. The presenting symptoms included multiple episodes of aphasia and right-sided weakness as well as a left basal ganglia infarct. The patient underwent treatment with two intracranial angioplasty procedures. There was a recurrence of the stenosis and symptoms following the first procedure. However, after a second treatment with a slightly larger balloon, flow in the MCA normalized. Furthermore, the symptoms attributed to her MCA stenosis had essentially resolved. This case suggests that patients with medically refractory idiopathic intracranial stenosis can be successfully treated with percutaneous transluminal angioplasty.

Arterial percutaneous angioplasty in hemodialysis access: Endovascular treatment of hand ischemia

2020 ◽  
pp. 112972982094665
Author(s):  
Gabriela Teixeira ◽  
Paulo Almeida ◽  
Luís Loureiro ◽  
Inês Antunes ◽  
Duarte Rego ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Vascular Access ◽  
Percutaneous Transluminal Angioplasty ◽  
Clinical Success ◽  
Invasive Procedure ◽  
Transluminal Angioplasty ◽  
Arterial Stenosis ◽  
Low Flow ◽  
Hemodialysis Access ◽  
Percutaneous Transluminal

Background: Hemodialysis access–induced distal ischemia consists of symptomatic extremity malperfusion after vascular access creation. It is usually caused by discordant vascular resistance, with arteriovenous shunting of a high blood volume from arterial into venous system and subsequent hand hypoperfusion. Less often, hemodialysis access–induced distal ischemia is caused by arterial stenosis. In these cases, access frequently has normal/low flow, radial pulse is usually absent and not recoverable with vascular access digital compression, diabetes is often present, and percutaneous transluminal angioplasty can be critical for access and limb salvage. Methods: Retrospective study conducted between June 2011 and February 2018 of patients with vascular access submitted to arterial percutaneous transluminal angioplasty for limb-threatening ischemia. Results: Twenty-nine patients were referred for arterial angiography after hemodialysis access–induced distal ischemia diagnosis and physical examination or ultrasound findings suggestive of arterial disease. In 11 patients, percutaneous transluminal angioplasty was not technically feasible. Among 18 treated patients, 83.3% had diabetes and 60% had skin ulcerations. Target arteries were radial (11), brachial (7), axillar (2), ulnar (2), and subclavian (1). Clinical success, defined as arteriovenous maintenance and wound healing/pain resolution, was observed in 12 patients (66.7%). Concomitant procedures included adjuvant banding ( n = 2) and finger amputation ( n = 1), and one reintervention was performed. No intra- or postoperative complications were reported. Conclusion: Hemodialysis access–induced distal ischemia is a serious complication of hemodialysis vascular access, with multifactorial etiology. Correct and timely diagnosis is crucial for maintaining access and limb salvage. Percutaneous transluminal angioplasty is a minimally invasive procedure that may be effective and long-lasting in carefully selected patients with ischemic complaints.

Successful transluminal angioplasty of renal arterial stenosis using the transcarotid approach

2002 ◽  
Vol 12 (6) ◽  
pp. 589-591 ◽  
Author(s):  
Kiyohiro Takigiku ◽  
Gengi Satomi ◽  
Satoshi Yasukochi
Keyword(s):  
Renal Artery ◽  
Renovascular Hypertension ◽  
Coronary Arteries ◽  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
Left Ventricular ◽  
Arterial Stenosis ◽  
Left Renal Artery ◽  
Ventricular Failure ◽  
Percutaneous Transluminal

We successfully performed percutaneous transluminal angioplasty to treat severe renovascular hypertension with left ventricular failure in a 5-month-old infant. Using the transcarotid approach, we dilated the stenotic left renal artery without any difficulties, using progressively larger balloons designed for dilation of coronary arteries.

scholarly journals Renal transplant arterial stenosis: percutaneous transluminal angioplasty

1983 ◽  
Vol 140 (2) ◽  
pp. 325-331 ◽  
Author(s):  
AJ Gerlock ◽  
RC MacDonell ◽  
CW Smith ◽  
CA Muhletaler ◽  
WC Parris ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
Arterial Stenosis ◽  
Percutaneous Transluminal

Percutaneous Transluminal Angioplasty for Atherosclerotic Stenosis of the Intracranial Cerebral Arteries

1998 ◽  
Vol 4 (1_suppl) ◽  
pp. 57-62 ◽  
Author(s):  
A. Hyodo ◽  
Y. Matsumaru ◽  
I. Anno ◽  
H. Sato ◽  
N. Kato ◽  
...  
Keyword(s):  
Percutaneous Transluminal Angioplasty ◽  
Cerebral Arteries ◽  
High Risk Patient ◽  
Transluminal Angioplasty ◽  
Point Of View ◽  
Stenotic Lesion ◽  
Atherosclerotic Stenosis ◽  
Percutaneous Transluminal ◽  
Stenotic Lesions

Percutaneous transluminal angioplasty (PTA) was carried out 43 times for 40 lesions in 38 cases of atheroscrelotic stenosis of the intracranial or skull base cerebral arteries. The stenotic lesions involved the middle cerebral artery in 15 cases, the basilar artery in seven cases, the internal carotid artery (petrous-supraclinoid portion) in 14 cases, and the intracranial vertebral artery in four cases. Nearly all cases were symptomatic, such as TIA or stroke, and the degree of stenosis ranged from 70 to 99 percent, with a mean of 80 percent. PTA was performed using a STEALTH balloon angioplasty catheter. In these trials, PTA was successfully performed (as indicated by a residual stenosis under 50%) 36 times. The initial success rate was 84% and stenosis was reduced from 80% to 25%. Clinical follow-up was performed from 3 to 62 months with a mean of 40 months. During this period, death due to myocardial infarction or pneumonia occurred in four cases, stroke related to previous PTA occurred in one case (due to re-stenosis) and stroke unrelated to previous PTA occurred in two cases. Angiographic follow-up was performed in 30 cases after 36 successful PTA procedures. Re-stenosis was seen in 20% of the cases, symptomatic complication occurred in 7%, and asymptomatic complications occurred in 7% of the cases. There was no mortality in this series. From analysis of complicated cases, there are several characteristic findings on the stenotic lesion. These are the stenotic lesions that located near the bifurcation, involving long segment, or showing irregular shape which is including ulcer or dissection. It is important to keep a fundamental and safe technique to reduce the complication. And besides, it is very important to keep the strict indication and to avoid the high-risk patient from a morphological point of view.

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