PURPOSE: Carotid artery stenting (CAS) may be an alternative to surgical endarterectomy not only in high-risk patients. Few data are available regarding the long-term clinical efficacy of CAS with the use of cerebral protection devices and the incidence of restenosis. Our experience demonstrates that if certain requirements are fulfilled, CAS can be considered a safe and effective treatment with high short-and long-term success rates. MATERIALS AND METHODS: In the past 8 years, we treated 1,003 patients (1,096 arteries) affected by internal carotid artery stenosis, 93 with bilateral stenosis. Of these, 567 (51.74%) were symptomatic and 529 (48.26%) asymptomatic lesions. The preprocedural evaluation was performed with Doppler ultrasound (US), magnetic resonance (MR) angiography/computed tomography (CT) angiography and a neurological evaluation. Antiplatelet therapy was administered before and after the procedure. RESULTS: Technical success was achieved in 1,092 cases (99.6%), and a cerebral protection device was successfully used in 1,019 procedures (92.9%). The 30-day transient ischaemic attack (TIA)/stroke/death rate was 2.16%: death (0.18%) major stroke (0.45%) and minor stroke/TIA (1.53%). During a follow-up up to 8 years, restenoses occurred in 39 cases (3.57%), of which 28 were post-CAS (2.57%) and 11 post-CAS performed for restenosis after carotid endarterectomy (1%). Only five symptomatic restenoses>80% were treated with a repeated endovascular procedure. CONCLUSIONS: A retrospective analysis of our experience suggests that CAS is a safe and effective procedure with better results than endarterectomy. In up to 8 years of follow-up, CAS seems to be effective in preventing stroke, with a low restenosis rate.
PURPOSE: Carotid artery stenting (CAS) may be an alternative to surgical endarterectomy not only in high-risk patients. Few data are available regarding the long-term clinical efficacy of CAS with the use of cerebral protection devices and the incidence of restenosis. Our experience demonstrates that if certain requirements are fulfilled, CAS can be considered a safe and effective treatment with high short-and long-term success rates. MATERIALS AND METHODS: In the past 8 years, we treated 1,003 patients (1,096 arteries) affected by internal carotid artery stenosis, 93 with bilateral stenosis. Of these, 567 (51.74%) were symptomatic and 529 (48.26%) asymptomatic lesions. The preprocedural evaluation was performed with Doppler ultrasound (US), magnetic resonance (MR) angiography/computed tomography (CT) angiography and a neurological evaluation. Antiplatelet therapy was administered before and after the procedure. RESULTS: Technical success was achieved in 1,092 cases (99.6%), and a cerebral protection device was successfully used in 1,019 procedures (92.9%). The 30-day transient ischaemic attack (TIA)/stroke/death rate was 2.16%: death (0.18%) major stroke (0.45%) and minor stroke/TIA (1.53%). During a follow-up up to 8 years, restenoses occurred in 39 cases (3.57%), of which 28 were post-CAS (2.57%) and 11 post-CAS performed for restenosis after carotid endarterectomy (1%). Only five symptomatic restenoses>80% were treated with a repeated endovascular procedure. CONCLUSIONS: A retrospective analysis of our experience suggests that CAS is a safe and effective procedure with better results than endarterectomy. In up to 8 years of follow-up, CAS seems to be effective in preventing stroke, with a low restenosis rate.
Authors: J Biller; W M Feinberg; J E Castaldo; A D Whittemore; R E Harbaugh; R J Dempsey; L R Caplan; T F Kresowik; D B Matchar; J F Toole; J D Easton; H P Adams; L M Brass; R W Hobson; T G Brott; L Sternau Journal: Circulation Date: 1998-02-10 Impact factor: 29.690
Authors: W S Moore; H J Barnett; H G Beebe; E F Bernstein; B J Brener; T Brott; L R Caplan; A Day; J Goldstone; R W Hobson Journal: Stroke Date: 1995-01 Impact factor: 7.914
Authors: Bernhard Reimers; Michael Schlüter; Fausto Castriota; Thilo Tübler; Nicola Corvaja; Carlo Cernetti; Raffaella Manetti; Amedeo Picciolo; Francesco Liistro; Carlo Di Mario; Alberto Cremonesi; Joachim Schofer; Antonio Colombo Journal: Am J Med Date: 2004-02-15 Impact factor: 4.965
Authors: Francesco Stilo; Nunzio Montelione; Rosalinda Calandrelli; Marisa Distefano; Francesco Spinelli; Vincenzo Di Lazzaro; Fabio Pilato Journal: Ann Transl Med Date: 2020-10