Eleven patients with supra-aortic artery stenoses were treated with percutaneous transluminal angioplasty (PTA). These cases included 8 vertebral arteries, 3 internal carotid arteries, and 2 subclavian arteries. Minor complications occurred in 3 cases. One internal carotid artery and 1 femoral artery suffered from intimal dissection; bradycardia and mild hypotention due to carotid sinus reflex occurred in another case. No permanent complications were experienced. Except for one stenosis at the origin of vertebral artery and one case of subclavian artery, stenoses were dilated with good results. During the follow-up of 3 to 12 months (mean: 9 months) in 10 patients, 3 stenoses at the origin of vertebral aretry were involved with restenosis. All the patients with stenoses of internal carotid arteries and trunk of vertebral arteries have been treated with satisfactory dilatations. In only 1 stenosis at the origin of vertebral artery, recurrent cerebellar infarction appeared 6 months after PTA.
According to pathological and hemodynamic studies, the stenoses of vertebral and subclavian arteries can be treated by PTA safely. However, for fear of embolism, the application of PTA in the stenoses of internal carotid arteries is still controversial. To prevent embolism, balloon-mounted guiding catheters were used in our internal carotid lesions. On the basis of our own results, PTA is a useful method for supra-aortic artery stenoses.