OBJECTIVETo evaluate the therapeutic effect of percutaneous transluminal angioplasty and stenting for occlusive lesions in supra-arch vessels with brain ischemic symptoms.

METHODSA total of 56 occlusive lesions of the innominate, subclavian, and internal carotid arteries were treated with angioplasty and intravascular stent placement in 52 patients. The degree of stenosis was more than 60% in all patients and the leading symptom was brain ischemia. In 11 patients, the occluded subclavian artery could not be crossed via the femoral route, therefore the brachial route was used and the occlusion was crossed in a retrograde fashion.

RESULTSTechnical success was achieved in 54 of 56 procedures (96.4%). Residual stenosis was less than 30% in all cases. The clinical symptoms improved after procedure in all patients. Complications occurred in 3 of 52 (5.8%) procedures, and the 30-day mortality rate was 0. There were no death and severe stroke in the follow-up period (means 24 months). Restenosis was observed in 2 patients after percutaneous transluminal angioplasty treatment.

CONCLUSIONPercutaneous transluminal angioplasty with or without stenting is a safe and valid choice for treatment of occlusive lesions of supra-arch vessels in patients with cerebral ischemic symptoms.