title: Outcomes following extracranial carotid artery stenting in high-risk patients.
abstract: BACKGROUND
  Carotid artery angioplasty and stenting has become a viable alternative to carotid endarterectomy (CEA), especially for patients considered at high risk for post-operative complications. This study investigated the feasibility, safety and long-term outcome of carotid artery stenting (CAS) in high-risk patients.
  
  
  METHODS
  From July 1995 to November 2000, sixty-two consecutive patients considered to be at high risk for post-operative complications of CEA were followed prospectively after undergoing extracranial CAS procedures.
  
  
  RESULTS
  Sixty-two patients [37 men (60%) and 25 women (40%)] underwent a total of 69 CAS procedures. The mean age was 67 +/- 9 years (range, 32-89 years). Comorbid conditions included hypertension in 95% and severe coronary artery disease in 58%. Sixteen patients (26%) had a previous ipsilateral CEA, twenty-one percent had a history of neck radiation and 32% had a history of significant contralateral carotid artery disease. Fifty-two patients (84%) were symptomatic. All 69 CAS procedures were technically successful. The major post-operative complications were two minor strokes (2.8%), one major stroke (1.4%) and one fatal major stroke (1.4%). The mean length of follow-up was 17 months (range, 4 months to 5.6 years). Two patients (2.8%) have suffered ipsilateral neurologic events following CAS. Long-term follow-up revealed restenosis at 6 months in 4 patients (5.7%).
  
  
  CONCLUSIONS
  Carotid artery angioplasty and stenting is safe and feasible. This procedure produces satisfactory outcomes in patients who are at high risk for post-operative complications of CEA.
authors.affiliation: Texas Heart Institute at St. Luke's Episcopl Hospital, Houston, TX 77030, USA.
authors.forename: D
authors.initials: D
authors.lastname: Paniagua
authors.forename: M
authors.initials: M
authors.lastname: Howell
authors.forename: N
authors.initials: N
authors.lastname: Strickman
authors.forename: J
authors.initials: J
authors.lastname: Velasco
authors.forename: K
authors.initials: K
authors.lastname: Dougherty
authors.forename: M
authors.initials: M
authors.lastname: Skolkin
authors.forename: B
authors.initials: B
authors.lastname: Toombs
authors.forename: Z
authors.initials: Z
authors.lastname: Krajcer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D002339:Carotid Arteries / Q000601:surgery*; D016893:Carotid Stenosis / Q000601:surgery; D016894:Endarterectomy, Carotid / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012886:Skull / Q000601:surgery*; D015607:Stents; D013995:Time; D016896:Treatment Outcome