BACKGROUND: Stroke represents the third leading cause of death in developed countries and the leading cause of disability in the elderly. Because asymptomatic, surgically high-risk patients have been systematically excluded from randomized trials of carotid endarterectomy and medical therapy, the management of this group of patients is still controversial. A single-centre, single-operator registry was analyzed to evaluate feasibility and safety of carotid artery stenting (CAS) with distal protection devices in consecutive, asymptomatic, surgically high-risk patients who were scheduled for endovascular treatment of significant carotid stenoses. METHODS: A total of 122 consecutive, surgically high-risk, asymptomatic patients (150 carotid arteries, 59% men, mean [± SD] age 69±9 years) with severe carotid stenosis and one or more high-risk features for carotid endarterectomy were scheduled for CAS. All procedures were performed in a single centre by a single operator. All patients were prospectively asked to undergo a clinical 30-day follow-up. RESULTS: A total of 154 stents were implanted in 150 carotid arteries. The primary success rate was 98.7%. The rates of stenosis before and after direct CAS were 81%±9% and 10%±13%, respectively. The median of fluoroscopic time of direct CAS was 6 min (range 2.5 min to 31.5 min). At 30 days, data were available in all patients. The combined 30-day mortality and stroke rate was 1.3%. CONCLUSIONS: Short-term outcomes of CAS in asymptomatic, surgically high-risk patients treated by a single operator suggest a low periprocedural complication rate.
BACKGROUND:Stroke represents the third leading cause of death in developed countries and the leading cause of disability in the elderly. Because asymptomatic, surgically high-risk patients have been systematically excluded from randomized trials of carotid endarterectomy and medical therapy, the management of this group of patients is still controversial. A single-centre, single-operator registry was analyzed to evaluate feasibility and safety of carotid artery stenting (CAS) with distal protection devices in consecutive, asymptomatic, surgically high-risk patients who were scheduled for endovascular treatment of significant carotid stenoses. METHODS: A total of 122 consecutive, surgically high-risk, asymptomatic patients (150 carotid arteries, 59% men, mean [± SD] age 69±9 years) with severe carotid stenosis and one or more high-risk features for carotid endarterectomy were scheduled for CAS. All procedures were performed in a single centre by a single operator. All patients were prospectively asked to undergo a clinical 30-day follow-up. RESULTS: A total of 154 stents were implanted in 150 carotid arteries. The primary success rate was 98.7%. The rates of stenosis before and after direct CAS were 81%±9% and 10%±13%, respectively. The median of fluoroscopic time of direct CAS was 6 min (range 2.5 min to 31.5 min). At 30 days, data were available in all patients. The combined 30-day mortality and stroke rate was 1.3%. CONCLUSIONS: Short-term outcomes of CAS in asymptomatic, surgically high-risk patients treated by a single operator suggest a low periprocedural complication rate.
Authors: Eric R Bates; Joseph D Babb; Donald E Casey; Christopher U Cates; Gary R Duckwiler; Ted E Feldman; William A Gray; Kenneth Ouriel; Eric D Peterson; Kenneth Rosenfield; John H Rundback; Robert D Safian; Michael A Sloan; Christopher J White Journal: J Am Coll Cardiol Date: 2007-01-02 Impact factor: 24.094
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: S Chaturvedi; A Bruno; T Feasby; R Holloway; O Benavente; S N Cohen; R Cote; D Hess; J Saver; J D Spence; B Stern; J Wilterdink Journal: Neurology Date: 2005-09-27 Impact factor: 9.910
Authors: Alberto Cremonesi; Carlo Setacci; Angelo Bignamini; Leonardo Bolognese; Francesco Briganti; Germano Di Sciascio; Domenico Inzitari; Gaetano Lanza; Luciano Lupattelli; Salvatore Mangiafico; Carlo Pratesi; Bernard Reimers; Stefano Ricci; Gianmarco de Donato; Ugo Ugolotti; Augusto Zaninelli; Gian Franco Gensini Journal: Stroke Date: 2006-08-10 Impact factor: 7.914
Authors: Christoph H Spes; Andreas Schwende; Florian Beier; Martin Hug; Ralph Hein; Henning Strohm; Wolfgang Büchele; Mathias C Haufe; Harald Mudra Journal: Clin Res Cardiol Date: 2007-08-17 Impact factor: 5.460
Authors: Paul T L Chiam; Gary S Roubin; Sriram S Iyer; Richard M Green; Daniel E Soffer; Christina Brennan; Jiri J Vitek Journal: Catheter Cardiovasc Interv Date: 2008-09-01 Impact factor: 2.692