title: Carotid artery stenting without angioplasty and cerebral protection: a single-center experience with up to 7 years' follow-up.
abstract: OBJECTIVE
  The use of cerebral protection during CAS in the treatment of carotid artery disease is matter of controversy. The purpose of this study was to evaluate the outcome of CASWBAP in a large cohort of patients, with ≤7 years' follow-up.
  
  
  METHODS
  Two hundred thirty-six patients with 255 symptomatic carotid stenoses and/or with high-risk-morphology plaques of >50% and asymptomatic plaques of >70% were prospectively identified. Patients underwent neurologic and carotid US examination before the procedure and during follow-up at 1, 3, 6, and 12 months and annually thereafter. Plain films of the neck were obtained immediately after the procedure and then at 1 and 3 months.
  
  
  RESULTS
  Technical success was achieved in 253/255 (99%) patients. Primary stent placement was successful in 248/253 (98%) patients. Neurologic periprocedural complications within 30 days included 1 (0.4%) nondisabling stroke, 1 (0.4%) disabling stroke, 11 (4.3%) TIAs, and 1 (0.4%) death. The mean duration of follow-up was 23 ± 1.4 months (range, 3-84 months). During the follow-up period, there were 9 additional deaths (7 unrelated to the carotid disease and 2 stroke-related) and 2 strokes (in other vascular territories). The degree of stenosis decreased from a mean of 82% before the procedure to a mean of 30% immediately after. During follow-up, 38 (14.8%) angioplasties were performed due to restenosis in 19 (7.4%) patients, lack of stent expansion in 14 (5.4%), or both in 5 (1.9%).
  
  
  CONCLUSIONS
  CASWBAP is effective and safe with a low incidence of periprocedural complications, providing satisfactory long-term clinical results.
authors.affiliation: Department of Endovascular Therapy, Hospiten Rambla Hospital, Santa Cruz de Tenerife, Spain. sebaldi73@yahoo.com
authors.forename: S
authors.initials: S
authors.lastname: Baldi
authors.forename: T
authors.initials: T
authors.lastname: Zander
authors.forename: M
authors.initials: M
authors.lastname: Rabellino
authors.forename: G
authors.initials: G
authors.lastname: González
authors.forename: M
authors.initials: M
authors.lastname: Maynar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy*; D002533:Cerebral Angiography; D002548:Cerebral Revascularization / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects; D020521:Stroke / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome