title: Safety and mid-term outcome of endovascular therapy for internal carotid artery disease: a 15-year experience at a single-centre angiology institution.
abstract: BACKGROUND
  Endovascular therapy of carotid artery disease has emerged as a potential alternative to endarterectomy and its clinical practise dramatically increased in many parts of the world. This study aims to determine the safety and mid-term outcome of carotid artery stenting (CAS) within a 15-year carotid program at a single-centre institution.
  
  
  METHODS
  We retrospectively analysed all CAS-procedures performed at our institution between 1995 and 2009.
  
  
  RESULTS
  During the observation period, a total of 497 CAS procedures were attempted in 460 patients with stenoses of the internal carotid artery of which 187 (37.6 %) were symptomatic and 310 (62.4 %) were asymptomatic. CAS was successful in 479 (96.4 %) cases and success rate significantly increased throughout the study (p < 0.001). The periprocedural complication rate for death, stroke, and transient ischemic attack (TIA) was 0.4 %, 1.2 %, and 2.6 %, respectively, and the cumulative event rate did not differ between symptomatic and asymptomatic patients (4.8 % vs. 3.9 %; p = 0.62). Age was the only significant predictor for the occurrence of any periprocedural adverse event (OR 2.08 [1.22 - 3.54]; p = 0.007). During a median follow-up of 24 [1; 141] months, the rate of stroke, TIA, and in-stent restenosis was 1.0 %, 2.2 %, and 2.7 %, respectively.
  
  
  CONCLUSIONS
  Data from this large observation in everyday clinical patients demonstrate that endovascular therapy in carotid artery disease can be performed safely and with mid-term outcomes comparable to carotid endarterectomy.
authors: Department of Internal Medicine I and German Heart Centre, Technische Universität München, Munich, Germany. t.ibrahim@lrz.tu-muenchen.de
authors: Tareq
authors: T
authors: Ibrahim
authors: Sebastian
authors: S
authors: Karmann
authors: Tibor
authors: T
authors: Schuster
authors: Massimiliano
authors: M
authors: Fusaro
authors: Ilka
authors: I
authors: Ott
authors: Corinna
authors: C
authors: Böttiger
authors: Makarios
authors: M
authors: Paschalidis
authors: Juliane K
authors: JK
authors: Hilger
authors: Holger
authors: H
authors: Poppert
authors: Wolfram
authors: W
authors: Theiss
authors: Nicolas
authors: N
authors: von Beckerath
mesh_terms: D000367:Age Factors; D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D002340:Carotid Artery Diseases / Q000150:complications / Q000401:mortality / Q000628:therapy*; D002343:Carotid Artery, Internal; D018572:Disease-Free Survival; D057505:Embolic Protection Devices; D005260:Female; D005858:Germany; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D020521:Stroke / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome