Carotid artery stenting: a single-centre experience with up to 8 years' follow-up.
Carotid artery stenting (CAS) may be an alternative to surgical endoarterectomy not only in high-risk patients. We report results in the endovascular treatment of carotid artery disease with up to 8 years' follow-up. In this retrospective study, we analysed data from 853 consecutive patients (946 arteries) treated for carotid artery stenosis between April 1999 and March 2007; 491 (52%) arteries were symptomatic and 455(48%) were asymptomatic. Preprocedural evaluation of the patients was performed with echo Doppler, magnetic resonance angiography (MRA) or computed tomographic angiography (CTA) and a neurological examination. A cerebral protection device was used in 879 (92.9%) procedures. Anti-platelet therapy was administered before and after the procedure. All patients were included in a follow-up of up to 8 years. Technical success was achieved in 943 (99.6%) lesions. At 30 days, there was a 0.21% (n = 2) death rate, a 0.42% major stroke rate, a 1.69% minor stroke/transient ischaemic attack (TIA) rate and a combined 2.32% TIA/stroke and death rate. During follow-up, echo Doppler evidenced restenosis in 39 (4.85%) cases; of these, only five, presenting restenosis >80%, were treated with an endovascular reintervention. At the long-term follow-up, two strokes (0.23%) were reported, which both occurred within the first 2 years. In our experience, carotid artery stenting seems to be a safe and effective treatment, providing satisfactory long-term clinical results.
Simonetti
Giovanni
G
Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, University Hospital Tor Vergata, Rome, Italy.
Gandini
Roberto
R
Versaci
Francesco
F
Pampana
Enrico
E
Fabiano
Sebastiano
S
Stefanini
Matteo
M
Spinelli
Alessio
A
Reale
Carlo Andrea
CA
Di Primio
Massimiliano
M
Gaspari
Eleonora
E
D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000379:methods; D002340:Carotid Artery Diseases / Q000628:therapy*; D016893:Carotid Stenosis / Q000628:therapy*; D023903:Coronary Restenosis; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000628:therapy; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000379:methods