Special technics for angioplasty of the brachiocephalic vessels

PURPOSE: Description of special techniques for retrograde angioplasty of cerebral arteries with protection of the brain. MATERIAL AND METHOD: During the last 3 years, 51 dilatations of cerebral vessels were carried out in 45 patients; in 8, special techniques were required. In cases with particular operative risks, angioplasty of cerebral vessels can be performed using various techniques (double catheter [8 cases], retrograde PTA [8 cases], kissing balloon technique [3 cases]). RESULTS: All stenoses were successfully dilated, using a local anaesthetic. One patient with a double stenosis of the common carotid artery developed severe headache and visual disturbances in the ipsilateral eye following dilatation of a tight stenosis with total remission of all symptoms within 24 hours. CONCLUSION: Stenoses of cerebral arteries where surgery would be difficult and associated with a high risk can be dilated by retrograde PTA using a double catheter technique with a low complication rate.