[Endovascular therapy of high-degree stenoses of the neck vessels-stent-supported percutaneous angioplasty of the carotid artery without cerebral protection].
OBJECTIVE
Technical essentials and therapeutic results of carotid stenting without cerebral protection are presented.


METHODS
In 161 patients, 167 high grade carotid stenoses were stented, followed by percutaneous transluminal angioplasty, with subsequent evaluation of the clinical and angiographic results. Diffusion-weighted MRI was carried out in 108 patients to detect cerebral sequelae.


RESULTS
Endovascular therapy was successful (residual stenosis < 25 %) in 166 stenoses (99.4 %). Twelve patients (7.5 %) had cerebrovascular complications within the 30-day perioperative period, seven of which occurred during the procedure. After treatment, diffusion-weighted MRI disclosed at least one new cerebral lesion in 40 patients (37 %), which were symptomatic in six patients.


CONCLUSIONS
Even without cerebral protection, high grade carotid stenosis can be safely treated with stent-protected percutaneous angioplasty. Microemboli detected by postoperative MRI are infrequently symptomatic.
Koch
C
C
Abteilung für Neuroradiologie, Universitätsklinikum Hamburg Eppendorf, Germany. ckoch@medinf.mu-luebeck.de
Kucinski
T
T
Eckert
B
B
Wittkugel
O
O
Röther
J
J
Zeumer
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D004617:Embolism / Q000175:diagnosis; D016894:Endarterectomy, Carotid; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011183:Postoperative Complications / Q000175:diagnosis; D015607:Stents; D020521:Stroke / Q000175:diagnosis / Q000209:etiology; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D018616:Ultrasonography, Doppler, Duplex