title: Endovascular stents for carotid artery occlusive disease.
abstract: OBJECTIVE
  To study the feasibility and safety of endovascular stenting of cervical carotid artery stenosis.
  
  
  METHODS
  Between April 1994 and May 1997, 108 consecutive patients (58 men; mean age 70.1 years) with > or = 70% carotid stenosis were treated with percutaneous stent implantation under a protocol that featured independent neurological review. Forty-four percent were asymptomatic. Over half the lesions (59%) were in the internal carotid artery; the mean stenosis was 86%. Palmaz stents were implanted without cerebral protection following preliminary balloon dilation; two Wallstents were used in long lesions.
  
  
  RESULTS
  Carotid stents were successfully placed in 108 of 114 (95%) lesions. Of the 6 technical failures, 5 were access related and 1 was due to seizures during balloon dilation. Two major (1.8%) and 2 minor (1.8%) strokes occurred (3.7% stroke rate for 108 patients; 3.5% in 114 procedures), all in symptomatic patients, one of whom died. There were 5 (4.4%) transient ischemic attacks and 2 (1.8%) brief seizure episodes during dilation. One patient died of a cardiac event on day 20. The all stroke or death rate was 5.3% based on 114 arteries at risk (5.6% in 108 patients). In the mean 6-month follow-up (range 1 to 36) of 97 eligible patients, 3 (3.1%) died from unrelated causes. There was 1 restenosis (1.0%) from a stent compression, which was successfully redilated. There were no neurological sequelae, cranial palsies, or cases of stent or vessel thrombosis in follow-up.
  
  
  CONCLUSIONS
  The use of stents in the treatment of cervical carotid occlusive disease appears feasible, effective in the short term, and without excessive risk of periprocedural stroke.
authors.affiliation: Department of Interventional Radiology, Louisiana State University Medical Center, New Orleans 70121, USA.
authors.forename: M H
authors.initials: MH
authors.lastname: Wholey
authors.forename: M H
authors.initials: MH
authors.lastname: Wholey
authors.forename: C R
authors.initials: CR
authors.lastname: Jarmolowski
authors.forename: G
authors.initials: G
authors.lastname: Eles
authors.forename: D
authors.initials: D
authors.lastname: Levy
authors.forename: J
authors.initials: J
authors.lastname: Buecthel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000150:complications / Q000401:mortality / Q000601:surgery*; D002404:Catheterization; D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011183:Postoperative Complications; D011446:Prospective Studies; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome