title: Mid-term outcomes of carotid artery stenting in patients with angiographic string sign.
abstract: OBJECTIVE
  To report on early and mid-term outcomes of carotid artery stenting (CAS) in patients with angiographic string sign (SS).
  
  
  BACKGROUND
  Little is known about the prognosis of patients with carotid SS treated by CAS.
  
  
  METHODS
  We retrospectively evaluated early and mid-term outcomes, together with ultrasound findings, in patients with SS treated by CAS at our institution.
  
  
  RESULTS
  Of 308 CAS procedures, SS was diagnosed in 6.2% (19 patients, 58% symptomatic). Carotid stent implantation was successful in 18 patients (success rate 95%). There were no peri-procedural adverse events. One patient suffered from a transient ischemic attack during hospitalization and died of pneumonia. All remaining patients completed a 30-day follow-up, and no complications were reported (asymptomatic restenosis was diagnosed in 1 patient and successfully redilated). Six patients died of causes unrelated to CAS (pneumonia, decompensated heart failure, and contralateral stroke) before completing a 6-month follow-up. However, these patients presented with more pronounced, unfavorable clinical and angiographic characteristics compared to the rest of the patients.
  
  
  CONCLUSIONS
  We suggest that CAS might be performed with acceptable procedural risk in patients presenting with SS, which is unsuitable for surgery. However, patients' clinical and angiographic characteristics must be carefully evaluated when considering interventional therapy, regardless of the favorable procedural outcomes.
authors.affiliation: Department of Cardiology-CardioVascular Center, University Hospital Motol, 2nd Medical School, Charles University, Prague, Czech Republic.
authors.forename: Miloslav
authors.initials: M
authors.lastname: Spacek
authors.forename: Lucie
authors.initials: L
authors.lastname: Martinkovicova
authors.forename: Petra
authors.initials: P
authors.lastname: Zimolova
authors.forename: Josef
authors.initials: J
authors.lastname: Veselka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D018153:Czech Republic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011859:Radiography; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome