title: Intravascular ultrasound assisted carotid artery stenting: randomized controlled trial. Preliminary results on 60 patients.
abstract: The primary aim is the evaluation of the usefulness of intravascular ultrasound (IVUS) in the identification of otherwise unnoticed complications during carotid stenting. The secondary aim is the evaluation of the impact of IVUS assistance in the procedural outcomes and long-term patency rates of carotid artery stenting.
  
  
  
  Sixty patients who underwent carotid artery stenting (CAS) during a 14-month period were evaluated prospectively. Thirty patients (50%) underwent IVUS assisted CAS, 30 patients (50%) underwent CAS using angiography as the unique diagnostic tool. All patients were enrolled through a primary duplex ultrasound evaluation; as a secondary evaluation, 54 patients (90%) underwent a preprocedural magnetic resonance angiography, whereas six patients (10%) underwent computed tomography-angiography. Patients with preocclusive stenoses (>85%) were excluded. Mean follow-up was 23 W 5.3 months.
  
  
  
  No periprocedural or late complications were observed. No statistical significance was observed in long-term stent patency between the two groups. Mean procedural time length of IVUS-assisted procedures was 10.3 W 5 min longer than non-IVUS-assisted procedures. Virtual histology (VH) IVUS evaluation of plaque morphology led to a different stent choice in three patients. In two cases, the IVUS assessment revealed a suboptimal stent deployment, solved by angioplasty; in one patient VH-IVUS detected plaque protrusion through stent cells, immediately treated by manual aspiration.
  
  
  
  Though not recommended as a routine intraprocedural evaluation, IVUS may be useful for a real-time CAS control when treating challenging plaques, such as 'soft' or lipidic ones or those prone to rupture, or whenever an intraprocedural morphologic evaluation is required for the appropriate stent choice, or when higher embolic risk is evaluated.
authors.affiliation: Università degli Studi di Roma 'Tor Vergata', Dipartimento di Biopatologia e Diagnostica per Immagini.|Fondazione 'PTV' -Policlinico 'Tor Vergata', Dipartimento di Diagnostica per Immagini, Imaging Molecolare, Radiologia Interventistica e Radioterapia, Rome, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Chiocchi
authors.affiliation: Università degli Studi di Roma 'Tor Vergata', Dipartimento di Biopatologia e Diagnostica per Immagini.|Fondazione 'PTV' -Policlinico 'Tor Vergata', Dipartimento di Diagnostica per Immagini, Imaging Molecolare, Radiologia Interventistica e Radioterapia, Rome, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Morosetti
authors.affiliation: Università degli Studi di Roma 'Tor Vergata', Dipartimento di Biopatologia e Diagnostica per Immagini.|Fondazione 'PTV' -Policlinico 'Tor Vergata', Dipartimento di Diagnostica per Immagini, Imaging Molecolare, Radiologia Interventistica e Radioterapia, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Chiaravalloti
authors.affiliation: Università degli Studi di Roma 'Tor Vergata', Dipartimento di Biopatologia e Diagnostica per Immagini.|Fondazione 'PTV' -Policlinico 'Tor Vergata', Dipartimento di Diagnostica per Immagini, Imaging Molecolare, Radiologia Interventistica e Radioterapia, Rome, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Loreni
authors.affiliation: Università degli Studi di Roma 'Tor Vergata', Dipartimento di Biopatologia e Diagnostica per Immagini.|Fondazione 'PTV' -Policlinico 'Tor Vergata', Dipartimento di Diagnostica per Immagini, Imaging Molecolare, Radiologia Interventistica e Radioterapia, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gandini
authors.affiliation: Università degli Studi di Roma 'Tor Vergata', Dipartimento di Biopatologia e Diagnostica per Immagini.|Fondazione 'PTV' -Policlinico 'Tor Vergata', Dipartimento di Diagnostica per Immagini, Imaging Molecolare, Radiologia Interventistica e Radioterapia, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Simonetti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D000066491:Clinical Decision-Making; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D000074286:Preliminary Data; D011446:Prospective Studies; D011474:Prosthesis Design; D012384:Rome; D012720:Severity of Illness Index; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D018084:Ultrasonography, Interventional; D014654:Vascular Patency