Percutaneous Transluminal Arterial Angioplasty (PTA) and Stenting
In percutaneous transluminal angioplasty (PTA), a surgeon threads a microcatheter — a long tube tipped with miniature instruments — into an artery to reopen it, usually with a tiny balloon. The surgeon may also use the catheter to place a tiny meshwork stent in the reopened artery to help keep it open.
PTA can be used to reopen blockages in intracranial arteries located between the brain and its middle membrane. These blockages are particularly dangerous because they rupture easily. PTA can also be used to reopen the carotid artery.
Using stents along with PTA evolved from experiences in heart disease treatment. While angioplasty is very effective at reopening closed arteries in the heart, some patients’ arteries close back up over time. Such closure is often tolerable in the heart, but is a more complicated issue in the basilar artery in the brain.
Some people have an alternative route for blood to get into the brain called posterior communicating artery collateral flow; they can tolerate basilar blockages fairly well. But for people without this flow, basilar blockages can be dangerous — so high reclosure rates would be unacceptable. Stents are a possible way to prevent reclosures, and are offered to all suitable patients as a standard part of treatment at MINC.
Patient Follow-up
Patient preparation prior to and after PTA and stenting is integral to achieving a good outcomes, especially when involving the arteries within the outer membrane covering the brain. UPMC specialists prescribe a number of medications before and after PTA and carefully monitor patients after the procedure to decrease the chances that a vessel will reclose, and to quickly identify reclosure if it occurs so it can be treated.