Angioplasty for cerebrovascular ischaemia good?

Possibly: Less validated than coronary and peripheral vascular ischemia, but some data suggests her may be a role. There is an increased risk of strokes with the procedure compared to surgery which needs to be factored into the decision.

Increases Strokes: While the goal of angioplasty is to reduce restriction of blood flow, both angioplasty & surgery increase shedding of debris from diseased arteries into the blood, blocking flow downstream with resulting strokes. The brain is less tolerant of this than heart & while damage occurs with both, it is more obvious with brain function. Aggressive medical tx of underlying factors driving disease safer.

Yes: If you have failed medical management and are high risk for surgery, then carotid angioplasty and stenting with distal protection should be considered. Find an experienced operator and the risk of stroke during the procedure can be as low as 1%, which rivals surgery results. I have been doing carotid stents since 1999 and this procedure has helped many of my patients.