Complications of carotid artery stenting.
OBJECTIVE
The aim of this study was to deal with complications that can be managed by vascular surgery.


METHODS
From March 2000 through May 2004, 171 patients (112 male, 59 female, mean age 66.2 years) underwent carotid artery stenting (CAS). Of these 171 interventions, 154 were CAS with percutaneous trasluminal angioplasty (PTA), 5 CAS without PTA, and 12 patients had only a PTA.


RESULTS
In 171 patients who received CAS, 5 suffered a stroke within 7 days and 3 a transient ischemic attack. Twenty-one percent of the patients developed an in-stent restenosis >50% within 6 months following the intervention. Twenty-two patients with a recurrent in-stent restenosis were treated by re-PTA. Eight patients of this group of 22 re-PTAs developed a recurrent in-stent restenosis. They were converted with patch angioplasty or PTFE interposition. These 8 conversions were performed without morbidity or mortality.


CONCLUSIONS
The preferable operative technique in patients with recurrent in-stent restenosis is open conventional operation with stent removal and patch angioplasty or graft interposition. The procedure can be performed at a low risk. In our series, we had no morbidity and mortality, and no cranial nerve lesion.
Raithel
D
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Department of Vascular Surgery, Klinikum Nürnberg-Süd, Nürnberg, Germany. dieter.raithel@rzmail.uni-erlangen.de
D000368:Aged; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects*; D020521:Stroke / Q000453:epidemiology / Q000209:etiology*; D015996:Survival Rate; D018616:Ultrasonography, Doppler, Duplex