scholarly journals Percutaneous Transluminal Angioplasty with Stent Placement versus Best Medical Therapy Alone in Symptomatic Intracranial Arterial Stenosis: A Best Evidence Review

Cureus ◽  
2018 ◽  
Author(s):  
Arjun Padalia ◽  
Jacob A Sambursky ◽  
Colby Skinner ◽  
Mouwafak Moureiden
Keyword(s):  
Medical Therapy ◽  
Stent Placement ◽  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
Arterial Stenosis ◽  
Intracranial Arterial Stenosis ◽  
Evidence Review ◽  
Best Medical Therapy ◽  
Percutaneous Transluminal

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.

Infrarenal Aortic Stenosis: Value of Stent Placement after Percutaneous Transluminal Angioplasty Failure

Radiology ◽  
2001 ◽  
Vol 219 (3) ◽  
pp. 655-662 ◽  
Author(s):  
Eric Therasse ◽  
Gary Côté ◽  
Vincent L. Oliva ◽  
Jean R. Cusson ◽  
Robert Wistaff ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Stent Placement ◽  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
Percutaneous Transluminal

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.

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