The significance of incomplete stent apposition in patients undergoing stenting of internal carotid artery stenosis.
OBJECTIVE
Incomplete stent apposition after carotid angioplasty and stent placement (CAS) is often seen but little is known about how the incomplete attachment goes after stent placement. For example, some may change into restenosis around the stent edge and some may remain unchanged. The purpose of this study is to clarify the morphologic prognosis of an incomplete stent apposition at the stent edge.


METHODS
CAS was attempted on 135 consecutive stenotic lesions (124 patients). Angiograms were then evaluated immediately after the procedure. An incomplete stent apposition at stent edge was found in 15 patients, and all of them were followed up by angiography and MR imaging with antiplatelet therapy.


RESULTS
No ischemic event caused by the lesions occurred during the mean follow-up period of 11 months (from 4 to 32 months). The angiography findings of 15 lesions at a mean of 8.8 months (from 2 to 28 months) after CAS showed that all remained unchanged. No patients required any additional intervention. No new ischemic lesions were detected in any of the 15 patients who underwent follow-up MR imaging at a mean of 10 months (from 2 to 32 months) after CAS.


CONCLUSIONS
In this study, the existence of a segment of incomplete stent apposition had no adverse morphologic or clinical effect.
Onizuka
M
M
Department of Neurosurgery, Fukuoka University Chikushi Hospital, 377-1 Ohara-Zokumyoin, Chikushino City, Fukuoka 818-8592, Japan.
Kazekawa
K
K
Nagata
S
S
Tsutsumi
M
M
Aikawa
H
H
Tomokiyo
M
M
Iko
M
M
Kodama
T
T
Nii
K
K
Matsubara
S
S
Tanaka
A
A
D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000295:instrumentation / Q000379:methods*; D001241:Aspirin / Q000627:therapeutic use; D002545:Brain Ischemia / Q000517:prevention & control; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011379:Prognosis; D015641:Radiography, Interventional; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D013988:Ticlopidine / Q000627:therapeutic use
D010975:Platelet Aggregation Inhibitors; D013988:Ticlopidine; D001241:Aspirin