Comparison of carotid artery stenting performance between cardiologists and neuroradiologists: one medical center's experience.
OBJECTIVE
To report the experience of carotid artery angioplasty with stenting (CAS) by cardiologists (CV) and neuroradiologists (NR) in an area with less incidence of extracranial artery stenosis.


METHODS
From 1999 to 2008, 210 patients with 231 stents were collected by claim records from the administrative office and reviewed by one independent neurologist. Outcome measures were peri-procedural adverse events (AE), restenosis and recurrent ipsilateral stroke (RS) rate, categorized into treatment groups by either CV or NR.


RESULTS
The average age was 69.0 years and 82.9 % of the patients were men. 63.8% of the patients with 62.8% stents were treated by CV and the remaining 36.2% of patients with 37.2% stents were done by NR. Symptomatic CAS was evident in 70.1% of the CV cases and 83.0% in NR treated patients (P = 0.017). The peri-procedural AE rate was 31.6%; 35.9% in CV group and 24.4% in the NR group (P = 0.071). RS rate was 4.8% in 663.3 days; 4.1% in 920.8 days in the CV group and 5.8% in 354.2 days in the NR group (P = 0.865). The restenosis rate was 10.9% in 630.5 days; 5.4% in the CV group in 224.8 days and 20.6% in the NR group in 817.8 days (P = 0.007).


CONCLUSIONS
The restenosis and recurrent stroke rates after carotid artery stenting in Taiwan appears to be consistent with other published and well organized trials. Measures to minimize peri-procedural AR rates are definitely warranted.
Wu
Yi-Shan
YS
Division of Cerebrovascular Diseases, Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Kuo
Yeh-Lin
YL
Wu
Chiung-Jen
CJ
Yip
Hon-Kan
HK
Hsu
Shih-Wei
SW
Liou
Chia-Wei
CW
Li
Tzu-Hui
TH
Lin
Hung-Sheng
HS
Tan
Teng-Yeow
TY
Chen
Wei-Hsi
WH
Chang
Ku-Chou
KC
D000368:Aged; D017130:Angioplasty; D002309:Cardiology; D016893:Carotid Stenosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011871:Radiology; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome