title: Unprotected carotid artery stenting: complications in 6 months follow-up.
abstract: BACKGROUND
  The most serious complications of carotid artery stenting (CAS) are related to the release of particles into the cerebral circulation. Although embolic protection devices may reduce the incidence of cerebral embolization, their use may be associated with additional complications including spasm or dissection. In this report, we present our experience with patients who underwent unprotected CAS.
  
  
  METHODS
  We prospectively enrolled patients with symptomatic internal carotid artery stenosis from October 2008 to June 2010.Stenosis diagnosed based on carotid duplex and/or CT angiography findings and confirmed by digital subtraction angiography. All stenting procedures were done without using a protection device. Neurologist evaluated neurological situation of the patients, 24 h, 30 days, 3 and 6 months after stenting. Patients had carotid duplex scan scheduled on the third and sixth month after the procedure.
  
  
  RESULTS
  Overall, 116patients underwent stenting; technical success rate was 100% .Mean age of patients was 68.48 ± 9.84 years, and 69% of the patients were male. One patient (1/116, 0.86%) developed transient ischemic attack during the procedure. One non-neurologic death (1/116, 0.86%) occurred 18 h after the procedure because of myocardial infarction. In 1-month follow-up, only one patient (1/115, 0.87%) presented with neurological complication as a consequence of thalamic hemorrhagic. Six months follow-up revealed two cases (2/115, 1.74%) with in-stent restenosis which one of them was severe and symptomatic and underwent angioplasty.
  
  
  CONCLUSIONS
  Unprotected carotid stenting appears to accompany with low early and late complications. Cerebral embolization during CAS is not the only cause of these complications and the use of cerebral protection devices may therefore not prevent all major complications including myocardial infarction, hyperperfusion syndrome, and re-stenosis.
authors.affiliation: Neuroscience Research Center (NSRC), Tabriz University of Medical Sciences, P.O Box 51665-348, Tabriz, Iran. diako30@yahoo.com
authors.forename: Reza
authors.initials: R
authors.lastname: Mohammadian
authors.forename: Bahram
authors.initials: B
authors.lastname: Sohrabi
authors.forename: Reza
authors.initials: R
authors.lastname: Mansourizadeh
authors.forename: Farideh
authors.initials: F
authors.lastname: Mohammadian
authors.forename: Babak
authors.initials: B
authors.lastname: Nasiri
authors.forename: Sajad
authors.initials: S
authors.lastname: Haririan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011183:Postoperative Complications; D011446:Prospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex
chemical_list: D010975:Platelet Aggregation Inhibitors