Carotid stenting for post-endarterectomy restenosis and radiation-induced occlusive disease.
Surgical treatment of carotid restenosis and radiation-induced occlusive disease is challenging because of the high morbidity and mortality associated with this procedure. Carotid stenting has been proposed as an alternative approach. We report a series of 8 patients who were treated via the percutaneous approach for either carotid restenosis (n = 4) or radiation-induced occlusive disease (n = 4). Technical success was achieved in all of the cases. There have been no deaths or strokes during the periprocedural or follow-up period. After dilation of the extracranial vessel, 1 patient experienced severe intracranial internal carotid arterial spasm that required stent placement. Wallstents were used in 6 patients and S.M.A.R.T. stents were used in the remaining 2. Restenosis occurred in 2 patients and was treated successfully with redilation or restenting. Carotid stenting appears to be a feasible and safe alternative to surgery for restenosis after carotid endarterectomy and for radiation-induced occlusive disease.
Hernandez-Vila
E
E
The Department of Cardiology, Texas Heart Institute and St. Luke's Episcopal Hospital, Houston, USA.
Strickman
N E
NE
Skolkin
M
M
Toombs
B D
BD
Krajcer
Z
Z
D001157:Arterial Occlusive Diseases / Q000209:etiology / Q000628:therapy*; D017536:Carotid Artery, Common; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000628:therapy*; D016894:Endarterectomy, Carotid; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000628:therapy*; D012008:Recurrence; D015607:Stents