Carotid angioplasty stenting revisited: clinical and radiological (MRI) outcome.
BACKGROUND
Although carotid angioplasty and stenting (CAS) is widely used to treat carotid stenosis, recent studies point to the inferiority of the procedure compared with carotid endarterectomy.


METHODS
We present 50 consecutive cases of CAS treated in our unit. Endarterectomy was contraindicated in these patients due to high operative risk. All the patients underwent a diffusion-weighted MRI (DWI) before and after the procedure and had a neurological assessment in a stroke unit.


RESULTS
No deaths were recorded until 30 days after the procedure. Six patients [12%, confidence interval at 95% (CI(95)) = 3.7-20.2] had a positive DWI MRI after the procedure but only 2 (4%, CI(95) = 0-9.43) had a worse neurological status.


CONCLUSIONS
This study shows that CAS is feasible with a low morbid-mortality rate in patients with a high surgical risk. DWI is highly sensitive to detect neurological complications after the procedure.
Ghorab
Karima
K
Department of Neurology, University Hospital of Limoges, Limoges, France.
Macian
Francisco
F
Adoukounou
Thierry
T
Magy
Laurent
L
Chapot
René
R
Vallat
Jean-Michel
JM
D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D016893:Carotid Stenosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D015331:Cohort Studies; D000075202:Contraindications; D038524:Diffusion Magnetic Resonance Imaging; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome