title: Carotid artery stenting: a single-centre experience with up to 8 years' follow-up.
abstract: 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.
authors.affiliation: Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, University Hospital Tor Vergata, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Simonetti
authors.forename: Roberto
authors.initials: R
authors.lastname: Gandini
authors.forename: Francesco
authors.initials: F
authors.lastname: Versaci
authors.forename: Enrico
authors.initials: E
authors.lastname: Pampana
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Fabiano
authors.forename: Matteo
authors.initials: M
authors.lastname: Stefanini
authors.forename: Alessio
authors.initials: A
authors.lastname: Spinelli
authors.forename: Carlo Andrea
authors.initials: CA
authors.lastname: Reale
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Di Primio
authors.forename: Eleonora
authors.initials: E
authors.lastname: Gaspari
mesh_terms: 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