[Carotid stenting: acute results and complications].
The treatment of carotid stenoses with balloon angioplasty and stenting is a new and not generally established method. During a one year period 65 patients (22 female, 43 male, mean age: 73 years, 47 with neurologic symptoms, 8 with contralateral carotid occlusion) with significant (>70%) carotid stenosis were treated with balloon angioplasty and balloon expandable stents. The primary technical success rate was 98% (65/66 patients) respectively 99% (69/70 stenoses). A combined procedure was performed in 11 /17%) patients with stenting in both carotid arteries in 4 patients with additional coronary interventions in 6 patients and stenting of the origin of the common carotid artery in one patient.Severe neurologic complications occurred in 4 (6.2%) patients (1 death, 1 major stroke, 2 minor strokes) and short lasting neurologic deficits in additional 4 (6.2%) patients. Cardiovascular complications were not observed. Local (inguinal) problems occurred in 3 (4.5%) patients (2 aneurysma spuria, 1 transfusion for hematoma). Frequently, balloon insufflation was associated with bradycardia (40%) and additional hypotension (11%). In summary, carotid stenting can be performed with technically high success rates (99%), but it is adversely influenced by not infrequent thromboembolic cerebral events (12.4%). The possibility to perform combined procedures with interventions in other vessels (both carotid arteries, coronary arteries, aortic arch arteries) is advantageous.
Leisch
F
F
Allgemeines Krankenhaus der Stadt Linz, 1. Medizinische Abteilung mit Kardiologie, Krankenhausstr. 9, A-4020 Linz, Osterreich.
Kerschner
K
K
Hofman
R
R
Bibl
D
D
Engleder
C
C
Bergmann
H
H
D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000295:instrumentation*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome