BACKGROUND: Although carotid angioplasty and stenting (CAS) is widely used to treat carotid stenosis, recent studies point to the inferiority of the procedure compared with carotid endarterectomy. METHODS: We present 50 consecutive cases of CAS treated in our unit. Endarterectomy was contraindicated in these patients due to high operative risk. All the patients underwent a diffusion-weighted MRI (DWI) before and after the procedure and had a neurological assessment in a stroke unit. RESULTS: No deaths were recorded until 30 days after the procedure. Six patients [12%, confidence interval at 95% (CI(95)) = 3.7-20.2] had a positive DWI MRI after the procedure but only 2 (4%, CI(95) = 0-9.43) had a worse neurological status. CONCLUSION: This study shows that CAS is feasible with a low morbid-mortality rate in patients with a high surgical risk. DWI is highly sensitive to detect neurological complications after the procedure. (c) 2007 S. Karger AG, Basel.
BACKGROUND: Although carotid angioplasty and stenting (CAS) is widely used to treat carotid stenosis, recent studies point to the inferiority of the procedure compared with carotid endarterectomy. METHODS: We present 50 consecutive cases of CAS treated in our unit. Endarterectomy was contraindicated in these patients due to high operative risk. All the patients underwent a diffusion-weighted MRI (DWI) before and after the procedure and had a neurological assessment in a stroke unit. RESULTS: No deaths were recorded until 30 days after the procedure. Six patients [12%, confidence interval at 95% (CI(95)) = 3.7-20.2] had a positive DWI MRI after the procedure but only 2 (4%, CI(95) = 0-9.43) had a worse neurological status. CONCLUSION: This study shows that CAS is feasible with a low morbid-mortality rate in patients with a high surgical risk. DWI is highly sensitive to detect neurological complications after the procedure. (c) 2007 S. Karger AG, Basel.