BACKGROUND: Carotid artery angioplasty and stenting has become a viable alternative to carotid endarterectomy (CEA), especially for patients considered at high risk for post-operative complications. This study investigated the feasibility, safety and long-term outcome of carotid artery stenting (CAS) in high-risk patients. METHODS: From July 1995 to November 2000, sixty-two consecutive patients considered to be at high risk for post-operative complications of CEA were followed prospectively after undergoing extracranial CAS procedures. RESULTS: Sixty-two patients [37 men (60%) and 25 women (40%)] underwent a total of 69 CAS procedures. The mean age was 67 +/- 9 years (range, 32-89 years). Comorbid conditions included hypertension in 95% and severe coronary artery disease in 58%. Sixteen patients (26%) had a previous ipsilateral CEA, twenty-one percent had a history of neck radiation and 32% had a history of significant contralateral carotid artery disease. Fifty-two patients (84%) were symptomatic. All 69 CAS procedures were technically successful. The major post-operative complications were two minor strokes (2.8%), one major stroke (1.4%) and one fatal major stroke (1.4%). The mean length of follow-up was 17 months (range, 4 months to 5.6 years). Two patients (2.8%) have suffered ipsilateral neurologic events following CAS. Long-term follow-up revealed restenosis at 6 months in 4 patients (5.7%). CONCLUSIONS: Carotid artery angioplasty and stenting is safe and feasible. This procedure produces satisfactory outcomes in patients who are at high risk for post-operative complications of CEA.
BACKGROUND: Carotid artery angioplasty and stenting has become a viable alternative to carotid endarterectomy (CEA), especially for patients considered at high risk for post-operative complications. This study investigated the feasibility, safety and long-term outcome of carotid artery stenting (CAS) in high-risk patients. METHODS: From July 1995 to November 2000, sixty-two consecutive patients considered to be at high risk for post-operative complications of CEA were followed prospectively after undergoing extracranial CAS procedures. RESULTS: Sixty-two patients [37 men (60%) and 25 women (40%)] underwent a total of 69 CAS procedures. The mean age was 67 +/- 9 years (range, 32-89 years). Comorbid conditions included hypertension in 95% and severe coronary artery disease in 58%. Sixteen patients (26%) had a previous ipsilateral CEA, twenty-one percent had a history of neck radiation and 32% had a history of significant contralateral carotid artery disease. Fifty-two patients (84%) were symptomatic. All 69 CAS procedures were technically successful. The major post-operative complications were two minor strokes (2.8%), one major stroke (1.4%) and one fatal major stroke (1.4%). The mean length of follow-up was 17 months (range, 4 months to 5.6 years). Two patients (2.8%) have suffered ipsilateral neurologic events following CAS. Long-term follow-up revealed restenosis at 6 months in 4 patients (5.7%). CONCLUSIONS: Carotid artery angioplasty and stenting is safe and feasible. This procedure produces satisfactory outcomes in patients who are at high risk for post-operative complications of CEA.
Authors: John D Barr; John J Connors; David Sacks; Joan C Wojak; Gary J Becker; John F Cardella; Bohdan Chopko; Jacques E Dion; Allan J Fox; Randall T Higashida; Robert W Hurst; Curtis A Lewis; Terence A S Matalon; Gary M Nesbit; J Arliss Pollock; Eric J Russell; David J Seidenwurm; Robert C Wallace Journal: AJNR Am J Neuroradiol Date: 2003 Nov-Dec Impact factor: 3.825
Authors: H Fukuda; K Iihara; N Sakai; K Murao; H Sakai; T Higashi; S Kogure; J Takahashi; K Hayashi; I Nagata Journal: Interv Neuroradiol Date: 2004-10-22 Impact factor: 1.610
Authors: Jai Jai Shiva Shankar; Jingwen Zhang; Marlise dos Santos; Howard Lesiuk; Ravi Mohan; Cheemun Lum Journal: Neuroradiology Date: 2012-04-21 Impact factor: 2.804
Authors: M D Hill; W Morrish; G Soulez; A Nevelsteen; G Maleux; C Rogers; K E Hauptmann; A Bonafé; R Beyar; L Gruberg; J Schofer Journal: AJNR Am J Neuroradiol Date: 2006-04 Impact factor: 3.825
Authors: Glenn M LaMuraglia; David C Brewster; Ashby C Moncure; David J Dorer; Michael C Stoner; Samir K Trehan; Elizabeth C Drummond; William M Abbott; Richard P Cambria Journal: Ann Surg Date: 2004-09 Impact factor: 12.969