Stent-assisted percutaneous angioplasty for extra-cranial carotid disease:experience at Singapore General Hospital.
BACKGROUND
This study aims to analyse the results of carotid stenting in a tertiary referral centre in Singapore.


METHODS
Retrospective analysis of all carotid artery stenting (CAS) cases in a single centre from March 1997 to December 2008 was performed. Sixty successful procedures were performed in 61 patients, with bilateral stenting in 1 patient, and 2 failed procedures. The majority were Chinese (78.7%) and males (77.0%), with a high proportion having hypertension (82.0%) and hypercholesterolaemia (78.7%). The majority (91.8%) of patients were high surgical risk candidates, primarily due to cardiac risk factors. Ten patients (16.4%) had prior neck irradiation for nasopharyngeal carcinoma, and 3 patients each (4.9%) had previous endarterectomy and contralateral occlusion. A distal embolic protection device was used in 71.7% of cases.


RESULTS
Technical success was 96.8%. The 30-day stroke and death rate was 13.8%, comparable to reported results for this high surgical risk population.


CONCLUSIONS
CAS is a technically feasible and a relatively safe alternative to endarterectomy to treat extracranial carotid stenosis, especially in patients who are inoperable or at high surgical risk.
Gogna
Apoorva
A
Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
Lath
Narayan
N
Chang
Hui Meng
HM
Tan
Bien Soo
BS
Wong
Meng Cheong
MC
Koh
Tian Hai
TH
Lim
Soo Teik
ST
Htoo
Maung Myint
MM
Lim
Winston E H
WE
D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000379:methods*; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D002340:Carotid Artery Diseases / Q000601:surgery*; D005260:Female; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012306:Risk; D012846:Singapore; D015607:Stents