[Endovascular treatment of carotid disease in patients at high surgical risk].
OBJECTIVE
To analyse the perioperative morbi-mortality rates during the first 30 days following endovascular therapy in patients with carotid stenosis and important risk factors for surgery. We also sought to determine the survival rate, the percentage of patients that were stroke-free and the percentage of cases of restenosis during the follow-up period.


METHODS
A retrospective study was conducted on a series of 100 patients with symptomatic > 50% and asymptomatic > 70% carotid stenosis, who underwent endovascular therapy between January 2000 and December 2006 because of the important risk factors they presented. Monitoring was clinical and was performed by means of carotid Doppler scanning.


RESULTS
The mean age of the sample: 72.2 years (46-86). Perioperative morbi-mortality of the series: 6% (confidence interval, CI 95% = 0.8-11.2) and in the symptomatic stenosis group: 5.7% (CI 95% = 1.8-12.9). The mean follow-up time was 23.4 months (0-94). Total mortality of the series during the follow-up was 7% (CI 95% = 1.4-12.5). The probability of survival at 3 and 5 years is 93 and 89%, respectively. At one year, 98.9% of the patients remained stroke-free. Restenosis of the stent occurred in 5% (CI 95% = 1.6-11.2). The probability of restenosis not occurring was 96.75% at 6 months and 94% at 3 years.


CONCLUSIONS
Stent angioplasty is an effective form of treatment in carotid stenosis in patients with important risk factors for surgery and it is therefore important to fulfil patient selection protocols and avoid perioperative complications.
López-Real
A
A
Complejo Hospitalario Universitario Juan Canalejo, 15006 A Coruna, Espana. analr_2000@yahoo.com
Mosteiro
S
S
Seoane
M
M
Díaz-Valiño
J L
JL
Martínez
A
A
Rubio-Nazábal
E
E
Marey-López
J
J
D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D016893:Carotid Stenosis / Q000628:therapy*; D023903:Coronary Restenosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors