title: Procedural outcome and midterm result of carotid stenting in high-risk patients.
abstract: Carotid endarterectomy is the standard treatment for carotid stenosis, but carotid artery stenting has emerged as a potential alternative. Elective carotid artery stenting was performed in 42 patients aged 42 to 79 years (mean, 67.05 +/- 8.67 years) after ultrasonography, computed tomography, magnetic resonance angiography and a neurological evaluation. There was bilateral carotid stenosis in 23 patients (55%), with > 90% stenosis in 18 vessels. All patients had significant associated coronary lesions. An emboli protection device and self-expanding stents were used. One year later, the patients were evaluated by Doppler sonography and selective angiography. Technical success was achieved in all procedures. During follow-up, 1 (2.4%) patient died from myocardial infarction, 1 underwent coronary artery bypass and 14 (40%) had minor complaints including occasional dizziness. No other neurological events were noted. Restenosis was found in one case, but selective angiography ruled out a significant lesion. One patient suffered embolization, but recovered completely within 24 hours. In 7 (17%) patients with type C arch interruption and a tortuous carotid course, stenting was successful and they had no embolization or restenosis. Carotid artery stenting is recommended in high-risk patients.
authors.affiliation: Namazi Hospital, Shiraz University of Medical Science, Zand Street, Shiraz, Iran. kojurij@yahoo.com
authors.forename: Javad
authors.initials: J
authors.lastname: Kojuri
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Ostovan
authors.forename: Nima
authors.initials: N
authors.lastname: Zamiri
authors.forename: Abdolali
authors.initials: A
authors.lastname: Zolghadr Asli
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Bani Hashemi
authors.forename: Afshin
authors.initials: A
authors.lastname: Borhani Haghighi
mesh_terms: D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D016893:Carotid Stenosis / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007492:Iran / Q000453:epidemiology; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011446:Prospective Studies; D011474:Prosthesis Design; D012008:Recurrence; D018570:Risk Assessment; D012720:Severity of Illness Index; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler