title: Perioperative and follow-up results in carotid artery stenting with contralateral carotid occlusion.
abstract: OBJECTIVE
  Contralateral carotid occlusion (CCO) increases the risk of carotid endarterectomy (CEA). We determined the outcome of carotid angioplasty and stenting (CAS), an alternative to CEA, in the setting of CCO through an independent analysis of imaging and clinical outcome.
  
  
  METHODS
  Medical records of 26 consecutive patients with CCO who underwent CAS by a single operator using the same procedural protocol (with distal protection and closed-cell stents) were retrospectively evaluated. National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (mRS) scores before and after CAS, periprocedural complications, and the restenosis rate were analyzed by independent stroke neurologists who were not involved in the care of the patients.
  
  
  RESULTS
  The median mRS score for the 26 patients was 1 (range 0-5) before and after CAS. All of the patients underwent clinical and imaging follow-up (mean 19.5 ± 14.3 and 11.6 ± 11.2 months, respectively). Thirty-day mortality/permanent morbidity rates were 0 %. One patient had hyperperfusion syndrome and was managed medically without sequelae; however, he had stent occlusion after 30 days, resulting in a decline in his mRS from 4 (preprocedure) to 5. Otherwise, there was no decline in mRS during the post-discharge follow-up.
  
  
  CONCLUSIONS
  According to an independent analysis of this single-operator series, CAS is safe and effective for the treatment of patients with CCO.
authors.affiliation: Department of Radiology, School of Medicine, Hacettepe University, Sıhhiye, 06100, Ankara, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Peker
authors.affiliation: Department of Neurology, School of Medicine, Ankara University, Ankara, Turkey.
authors.forename: Mine Hayriye
authors.initials: MH
authors.lastname: Sorgun
authors.affiliation: Department of Neurology, School of Medicine, Ankara University, Ankara, Turkey.
authors.forename: Canan Togay
authors.initials: CT
authors.lastname: Isikay
authors.affiliation: Department of Neurology, School of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Ethem Murat
authors.initials: EM
authors.lastname: Arsava
authors.affiliation: Department of Neurology, School of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Topcuoglu
authors.affiliation: Department of Radiology, School of Medicine, Hacettepe University, Sıhhiye, 06100, Ankara, Turkey. anilarat@hotmail.com.
authors.forename: Anil
authors.initials: A
authors.lastname: Arat
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D000800:Angioplasty, Balloon; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000601:surgery; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D000072226:Computed Tomography Angiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler
keywords: Carotid angioplasty; Carotid occlusion; Carotid stenting; Distal protection; Stroke