Long-term follow-up of patients after carotid stenting with or without distal protective device in a single tertiary medical center.
OBJECTIVE
To evaluate the immediate and long-term clinical outcomes after carotid artery stenting (CAS) with and without protection devices (PDs), compared with carotid endarterectomy (CEA).


METHODS
A total of 116 patients with symptomatic carotid stenosis underwent CAS; 56 patients (48.3%) underwent CAS-PD; and 137 patients underwent CEA.


RESULTS
There were more ipsilateral transient ischemic attacks (TIAs) in the CEA group than in CAS-PD and CAS + PD (4 [3%] vs 1 [1.6%] and 0 respectively, P = 0.02). In the CAS-PD group there were more vertebrobasilar TIAs, ipsi- and contralateral strokes, myocardial infarctions, and death rates in the 30-day postprocedural period. After 8-year follow-up, there were 18 (30%) death cases in the CAS-PD group, 10 death cases (17%) in the CAS + PD patients, and 15 death cases (11%) in the CEA group of patients (P = .02).


CONCLUSIONS
Our data show that CAS + PD was associated with lower rate of vascular complications and mortality compared with CAS-PD and CEA.
Department of Neurology, Assaf Harofeh Medical Center, Zerifin, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
Itzhak
I
Kimiagar
Alexander Y
AY
Gur
Eitan
E
Auriel
Amir
A
Peer
Tzvika
T
Sacagiu
Arie
A
Bass
D000368:Aged; D000704:Analysis of Variance; D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D016893:Carotid Stenosis / Q000150:complications / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D057505:Embolic Protection Devices; D016894:Endarterectomy, Carotid; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology / Q000517:prevention & control; D007557:Israel; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors; D015607:Stents; D020521:Stroke / Q000209:etiology / Q000517:prevention & control; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome