title: External carotid artery stenosis after internal and common carotid stenting.
abstract: BACKGROUND
  The external carotid artery (ECA) can be an important collateral for cerebral perfusion in the presence of severe internal carotid artery (ICA) disease. ICA stenting that covers the ECA origin may put the ECA at increased risk of stenosis. Our objective was to determine the rate of ECA stenosis secondary to ICA stenting, determine predictive factors, and describe any subsequent associated symptoms.
  
  
  METHODS
  We retrospectively reviewed clinical data on all ICA stents crossing the origin of the ECA placed by vascular surgeons at our institution. We analyzed patient demographics, comorbidities, stent type and sizes, as well as medication profile to determine predictors of ECA stenosis.
  
  
  RESULTS
  Between 2005 and 2013, there were 72 (out of 119 total ICA stenting) patients (mean age 71, 68% male) who underwent placement of ICA stents that also crossed the origin of the ECA. Six patients (8.3%) had a significantly increased ECA stenosis postprocedure. There were no occlusions. All patients with ECA stenosis maintained patency of their ICA stent and were asymptomatic. Age, gender, comorbidities, stent type and size, and medication profile were not associated with ECA stenosis after stenting.
  
  
  CONCLUSIONS
  ECA stenosis after ICA stenting covering the ECA origin is uncommon and not clinically significant in patients with patent ICA stents. The clinical significance of concurrent ECA and ICA stenosis after stenting is unclear as it is not captured here. The potential for ECA stenosis should not deter stenting across the ECA origin if necessary. Patient and stent factors are not predictive of ECA stenosis.
authors.affiliation: Section of Vascular Surgery and Endovascular Interventions, New York-Presbyterian Hospital, Columbia University, College of Physicians and Surgeons, New York, NY. Electronic address: jeffrey.siracuse@bmc.org.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Siracuse
authors.affiliation: Section of Vascular Surgery and Endovascular Interventions, New York-Presbyterian Hospital, Columbia University, College of Physicians and Surgeons, New York, NY.
authors.forename: Irene
authors.initials: I
authors.lastname: Epelboym
authors.affiliation: Section of Vascular Surgery and Endovascular Interventions, New York-Presbyterian Hospital, Columbia University, College of Physicians and Surgeons, New York, NY.
authors.forename: Boyangzi
authors.initials: B
authors.lastname: Li
authors.affiliation: Section of Vascular Surgery and Endovascular Interventions, New York-Presbyterian Hospital, Columbia University, College of Physicians and Surgeons, New York, NY.
authors.forename: Rahima
authors.initials: R
authors.lastname: Hoque
authors.affiliation: Section of Vascular Surgery and Endovascular Interventions, New York-Presbyterian Hospital, Columbia University, College of Physicians and Surgeons, New York, NY.
authors.forename: Diana
authors.initials: D
authors.lastname: Catz
authors.affiliation: Section of Vascular Surgery and Endovascular Interventions, New York-Presbyterian Hospital, Columbia University, College of Physicians and Surgeons, New York, NY.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Morrissey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects* / Q000295:instrumentation*; D017536:Carotid Artery, Common / Q000503:physiopathology; D002342:Carotid Artery, External / Q000503:physiopathology; D002343:Carotid Artery, Internal / Q000503:physiopathology; D016893:Carotid Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency