Outcomes following extracranial carotid artery stenting in high-risk patients

• Published in: The Journal of invasive cardiology Vol. 13; no. 5; pp. 375 - 381
• Main Authors: Paniagua, D, Howell, M, Strickman, N, Velasco, J, Dougherty, K, Skolkin, M, Toombs, B, Krajcer, Z
• Format: Journal Article
• Language: English
• Published: United States 01.05.2001
• Subjects: Aged; Aged, 80 and over; Angioplasty; Carotid Arteries - surgery; Carotid Stenosis - surgery; Endarterectomy, Carotid - adverse effects; Female; Follow-Up Studies; Humans; Length of Stay; Male; Middle Aged; Postoperative Complications - etiology; Prospective Studies; Recurrence; Risk Factors; Skull - surgery; Stents; Time; Treatment Outcome
• ISSN: 1042-3931

Carotid artery angioplasty and stenting has become a viable alternative to carotid endarterectomy (CEA), especially for patients considered at high risk for post-operative complications. This study investigated the feasibility, safety and long-term outcome of carotid artery stenting (CAS) in high-risk patients. From July 1995 to November 2000, sixty-two consecutive patients considered to be at high risk for post-operative complications of CEA were followed prospectively after undergoing extracranial CAS procedures. Sixty-two patients [37 men (60%) and 25 women (40%)] underwent a total of 69 CAS procedures. The mean age was 67 +/- 9 years (range, 32-89 years). Comorbid conditions included hypertension in 95% and severe coronary artery disease in 58%. Sixteen patients (26%) had a previous ipsilateral CEA, twenty-one percent had a history of neck radiation and 32% had a history of significant contralateral carotid artery disease. Fifty-two patients (84%) were symptomatic. All 69 CAS procedures were technically successful. The major post-operative complications were two minor strokes (2.8%), one major stroke (1.4%) and one fatal major stroke (1.4%). The mean length of follow-up was 17 months (range, 4 months to 5.6 years). Two patients (2.8%) have suffered ipsilateral neurologic events following CAS. Long-term follow-up revealed restenosis at 6 months in 4 patients (5.7%). Carotid artery angioplasty and stenting is safe and feasible. This procedure produces satisfactory outcomes in patients who are at high risk for post-operative complications of CEA.