Outcomes for overlapping stents in the extracranial carotid artery.
Various diseases of the carotid artery are treatable by stenting. However, few reports of overlapping carotid stents exist. As a result, the indications, long-term outcomes, and potential complications of this technique remain largely unknown. We therefore present and examine a series of 11 patients treated by this unique stenting method. A retrospective single-institution review was performed for patients in whom overlapping carotid stents were placed. Only patients with imaging follow-up beyond 3 months were included. Of 38 patients who had extracranial carotid artery stents placed, 11 patients fulfilled the inclusion criteria for both overlapping stents and imaging follow-up greater than 3 months (range, 0.4-3 years; mean, 1.3 years). Clinical follow-up ranged between 0.4 and 3.6 years (mean, 2.1 years). Carotid pathology within this cohort included atheromatous stenosis (n = 3), recurrent stenosis following carotid endarterectomy (n = 2) or stenting (n = 1), postirradiation angiitis (n = 1), carotid artery kink created by initial stent placement (n = 2), and both traumatic (n = 1) and neoplastic (n = 1) carotid blowout syndrome. No permanent stroke or stenting-related death occurred. Focal stenosis or intimal hyperplasia resulting in 35% or less luminal narrowing developed in three patients (27%) after tandem stenting. Overlapping stents provide a durable treatment for a variety of extracranial carotid pathologies. Clinically and hemodynamically significant (> 50%) poststenting stenosis or intimal hyperplasia did not occur in this series.
Lesley
Walter S
WS
Section of Surgical Neuroradiology, Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA. lesleyws@slu.edu
Weigele
John B
JB
Chaloupka
John C
JC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D016893:Carotid Stenosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome