title: Carotid artery stenting with routine cerebral protection in high-risk patients.
abstract: BACKGROUND
  Carotid artery stenting has emerged as an alternative treatment modality in carotid occlusive disease. This study examined our experience of carotid stenting with routine cerebral embolization protection in high-risk patients.
  
  
  METHODS
  Clinical variables and treatment outcome of high-risk patients who underwent carotid stenting with neuroprotection were analyzed during a 26-month period.
  
  
  RESULTS
  Sixty-eight high-risk patients with 72 carotid artery stenoses were treated. Procedural success was achieved in 70 cases (97%), and symptomatic lesions existed in 17 (24%) patients. Monorail Wallstents stents were used in all cases. Neuroprotective devices used were PercuSurge (28%) and Filterwire (72%). There was no periprocedural mortality or neuroprotective device-related complications. The 30-day stroke and death rate was 2.7%, and the overall complication rate was 6.9%. All stented vessels remained patent during the follow-up period (mean 15.3 +/- 4.2, range 1 to 23 months). Two asymptomatic in-stent restenosis (3%) occurred at 6 and 8 months, which were both successfully treated with balloon angioplasty.
  
  
  CONCLUSIONS
  Our study showed that percutaneous carotid stenting with routine use of a cerebral protection device is a feasible and effective treatment in high-risk patients with carotid occlusive disease.
authors.affiliation: Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine and the Methodist Hospital, HVAMC (112), 2002 Holcombe Blvd., Houston, TX 70030, USA. plin@bcm.tmc.edu
authors.forename: Peter H
authors.initials: PH
authors.lastname: Lin
authors.forename: Ruth L
authors.initials: RL
authors.lastname: Bush
authors.forename: Dieter F
authors.initials: DF
authors.lastname: Lubbe
authors.forename: Mitchell M
authors.initials: MM
authors.lastname: Cox
authors.forename: Wei
authors.initials: W
authors.lastname: Zhou
authors.forename: Sally A
authors.initials: SA
authors.lastname: McCoy
authors.forename: Deborah
authors.initials: D
authors.lastname: Felkai
authors.forename: Ramesh
authors.initials: R
authors.lastname: Paladugu
authors.forename: Alan B
authors.initials: AB
authors.lastname: Lumsden
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000295:instrumentation / Q000379:methods*; D002545:Brain Ischemia / Q000517:prevention & control*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008851:Micropore Filters; D008875:Middle Aged; D011482:Protective Devices; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler