External carotid artery angioplasty in cerebrovascular insufficiency

Percutaneous angioplasty can be used for the treatment of selected cases of vascular disease involving the brachiocephalic vessels. Our experience so far is limited, but from this limited experience and the scarce data from the literature regarding this subject, it appears that this procedure may be of significant value. We believe that the role of this procedure can be expanded, in the future, to cover more categories of vascular disease in the head and neck region. For the time being, we believe that it is safe to perform angioplasty of the external carotid artery prior to the creation of an extracranial-intracranial anastomosis or to increase blood flow through an existing spontaneous extracranial-intracranial anastomosis if the patient refuses the surgery. Contraindications to the procedure have been enumerated. These guidelines must be observed carefully to prevent any complications.