title: Carotid artery stenting in asymptomatic and surgically high-risk patients: single-centre, single-operator results.
abstract: BACKGROUND
  Stroke represents the third leading cause of death in developed countries and the leading cause of disability in the elderly. Because asymptomatic, surgically high-risk patients have been systematically excluded from randomized trials of carotid endarterectomy and medical therapy, the management of this group of patients is still controversial. A single-centre, single-operator registry was analyzed to evaluate feasibility and safety of carotid artery stenting (CAS) with distal protection devices in consecutive, asymptomatic, surgically high-risk patients who were scheduled for endovascular treatment of significant carotid stenoses.
  
  
  METHODS
  A total of 122 consecutive, surgically high-risk, asymptomatic patients (150 carotid arteries, 59% men, mean [± SD] age 69±9 years) with severe carotid stenosis and one or more high-risk features for carotid endarterectomy were scheduled for CAS. All procedures were performed in a single centre by a single operator. All patients were prospectively asked to undergo a clinical 30-day follow-up.
  
  
  RESULTS
  A total of 154 stents were implanted in 150 carotid arteries. The primary success rate was 98.7%. The rates of stenosis before and after direct CAS were 81%±9% and 10%±13%, respectively. The median of fluoroscopic time of direct CAS was 6 min (range 2.5 min to 31.5 min). At 30 days, data were available in all patients. The combined 30-day mortality and stroke rate was 1.3%.
  
  
  CONCLUSIONS
  Short-term outcomes of CAS in asymptomatic, surgically high-risk patients treated by a single operator suggest a low periprocedural complication rate.
authors.affiliation: Cardiovascular Center, University Hospital Motol, 1st Medical School, Prague, Czech Republic Prague, Czech Republic. veselka.josef@seznam.cz
authors.forename: Josef
authors.initials: J
authors.lastname: Veselka
authors.forename: Petra
authors.initials: P
authors.lastname: Zimolová
authors.forename: Daniela
authors.initials: D
authors.lastname: Cerná
authors.forename: Pavel
authors.initials: P
authors.lastname: Stanka
authors.forename: Aleš
authors.initials: A
authors.lastname: Tomek
authors.forename: Martin
authors.initials: M
authors.lastname: Srámek