Percutaneous Angioplasty of

A technique for safe angioplasty of atherosclerotic stenosis of internal and common carotid arteries is described in which temporary balloon occlusion of the internal carotid artery is used to prevent cerebral embolization during manipulation of ulcerated plaques. Its successful use in six atherosclerotic stenoses is described. Five angioplasties of postsurgical stenoses are also reported in which the technique of temporary occlusion was not used. The future of carotid artery angioplasty is discussed. Since its first description [1] and the introduction of double-balloon dilatation catheters [2] , percutaneous transluminal angioplasty has become a well-established technique for treating arterial stenoses in various regions. Application of angioplasty to supraaortic arteries has lagged behind that in other regions [3-6] ; only a few instances of angioplasty in atherosclerotic stenosis of the internal or common carotid artery have been reported [7-10] , and the fear of dislodging an embolus from an ulcerative plaque [11] is still a common objection to this technique. We describe our experience with temporary distal balloon occlusion of the internal carotid artery to protect the cerebral circulation during angioplasty of six athero