Angioplasty and stenting for high-grade internal carotid artery stenosis: safety study in 39 selected patients.
BACKGROUND
Carotid angioplasty and stenting (CAS) is sometimes used as an alternative to surgery, despite the lack of evidence for its safety and efficacy.


METHODS
Over a 33-month period, 39 consecutive patients with a stenosis >/=70% underwent CAS (4 in a randomized trial and 35 because of contra-indications for surgery).


RESULTS
In 5 patients (13%; 95% CI: 3-23), a major complication occurred (3 disabling ischaemic strokes, 1 myocardial infarction, 1 acute interstitial nephropathy). In 7 patients (18%; 95% CI: 6-30), a minor complication occurred (5 transient ischaemic attacks, 1 transient confusional state, 1 non-disabling ischaemic stroke).


CONCLUSIONS
CAS cannot be considered as a routine procedure and should be restricted to high-risk patients unfit for surgery.
Debette
S
S
Department of Neurology (EA 2691), Lille University Hospital, France.
Hénon
H
H
Gauvrit
J Y
JY
Haulon
S
S
Mackowiak-Cordoliani
M A
MA
Gautier
C
C
Deplanque
D
D
Lucas
C
C
Leclerc
X
X
Koussa
M
M
Pruvo
J P
JP
Leys
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D002343:Carotid Artery, Internal / Q000601:surgery*; D016893:Carotid Stenosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D015607:Stents; D020521:Stroke / Q000401:mortality; D016896:Treatment Outcome