Stent-assisted percutaneous angioplasty for extra-cranial carotid disease:experience at Singapore General Hospital

• Published in: Annals of the Academy of Medicine, Singapore Vol. 38; no. 9; pp. 756 - 762
• Main Authors: Gogna, Apoorva, Lath, Narayan, Chang, Hui Meng, Tan, Bien Soo, Wong, Meng Cheong, Koh, Tian Hai, Lim, Soo Teik, Htoo, Maung Myint, Lim, Winston E H
• Format: Journal Article
• Language: English
• Published: Singapore 01.09.2009
• Subjects: Aged; Aged, 80 and over; Angioplasty - methods; Angioplasty, Balloon, Coronary - methods; Carotid Artery Diseases - surgery; Female; Hospitals, General; Humans; Male; Middle Aged; Outcome Assessment (Health Care); Retrospective Studies; Risk; Singapore; Stents; Singapore
• ISSN: 0304-4602; 0304-4602
• DOI: 10.47102/annals-acadmedsg.V38N9p756

This study aims to analyse the results of carotid stenting in a tertiary referral centre in Singapore. Retrospective analysis of all carotid artery stenting (CAS) cases in a single centre from March 1997 to December 2008 was performed. Sixty successful procedures were performed in 61 patients, with bilateral stenting in 1 patient, and 2 failed procedures. The majority were Chinese (78.7%) and males (77.0%), with a high proportion having hypertension (82.0%) and hypercholesterolaemia (78.7%). The majority (91.8%) of patients were high surgical risk candidates, primarily due to cardiac risk factors. Ten patients (16.4%) had prior neck irradiation for nasopharyngeal carcinoma, and 3 patients each (4.9%) had previous endarterectomy and contralateral occlusion. A distal embolic protection device was used in 71.7% of cases. Technical success was 96.8%. The 30-day stroke and death rate was 13.8%, comparable to reported results for this high surgical risk population. CAS is a technically feasible and a relatively safe alternative to endarterectomy to treat extracranial carotid stenosis, especially in patients who are inoperable or at high surgical risk.