Evolving indications for and early results of carotid artery stenting.
BACKGROUND
While carotid endarterectomy continues to be the gold standard of treatment for most patients with significant carotid artery disease, there are cases where lesion or anatomy-related factors create situations less than ideal for conventional surgery. Other therapeutic modalities, such as endoluminal stenting, may represent reasonable options for such patients.


METHODS
Thirty-three patients with 70% or greater internal carotid artery lesions were treated by endovascular stent placement from July 1994 through June 1996. Indications included transient ischemic attacks in 20 and previous stroke in 4; and 9 were asymptomatic.


RESULTS
Stents were placed successfully in all instances. Mortality and stroke rates were zero. All patients remained asymptomatic during follow-up (mean 8 months), and stent patency by duplex ultrasound has been 100%. A single instance of intrastent restenosis has been observed.


CONCLUSIONS
Endoluminal stenting is an investigational technique of unproven efficacy and long-term durability. Yet it appears technically feasible, and possibly reasonable, as an alternate option for cases unfavorable for standard surgery.
Criado
F J
FJ
Division of Vascular Surgery, Union Memorial Hospital, Baltimore, Maryland, USA.
Wellons
E
E
Clark
N S
NS
D016893:Carotid Stenosis / Q000150:complications / Q000601:surgery*; D000075202:Contraindications; D016894:Endarterectomy, Carotid; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018579:Patient Selection; D015607:Stents; D016896:Treatment Outcome