Carotid artery stenting: a single-centre experience with up to 8 years' follow-up

Eur Radiol. 2009 Apr;19(4):982-9. doi: 10.1007/s00330-008-1207-3. Epub 2008 Nov 6.

Abstract

Carotid artery stenting (CAS) may be an alternative to surgical endoarterectomy not only in high-risk patients. We report results in the endovascular treatment of carotid artery disease with up to 8 years' follow-up. In this retrospective study, we analysed data from 853 consecutive patients (946 arteries) treated for carotid artery stenosis between April 1999 and March 2007; 491 (52%) arteries were symptomatic and 455(48%) were asymptomatic. Preprocedural evaluation of the patients was performed with echo Doppler, magnetic resonance angiography (MRA) or computed tomographic angiography (CTA) and a neurological examination. A cerebral protection device was used in 879 (92.9%) procedures. Anti-platelet therapy was administered before and after the procedure. All patients were included in a follow-up of up to 8 years. Technical success was achieved in 943 (99.6%) lesions. At 30 days, there was a 0.21% (n = 2) death rate, a 0.42% major stroke rate, a 1.69% minor stroke/transient ischaemic attack (TIA) rate and a combined 2.32% TIA/stroke and death rate. During follow-up, echo Doppler evidenced restenosis in 39 (4.85%) cases; of these, only five, presenting restenosis >80%, were treated with an endovascular reintervention. At the long-term follow-up, two strokes (0.23%) were reported, which both occurred within the first 2 years. In our experience, carotid artery stenting seems to be a safe and effective treatment, providing satisfactory long-term clinical results.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angioplasty / methods
  • Carotid Artery Diseases / therapy*
  • Carotid Stenosis / therapy*
  • Coronary Restenosis
  • Female
  • Humans
  • Ischemic Attack, Transient / diagnosis
  • Ischemic Attack, Transient / therapy
  • Magnetic Resonance Angiography / methods
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stents*
  • Treatment Outcome
  • Ultrasonography, Doppler / methods