RT Journal Article
SR Electronic
T1 Carotid Artery Stenting without Angioplasty and Cerebral Protection: A Single-Center Experience with up to 7 Years' Follow-Up
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 759
OP 763
DO 10.3174/ajnr.A2375
VO 32
IS 4
A1 Baldi, S.
A1 Zander, T.
A1 Rabellino, M.
A1 González, G.
A1 Maynar, M.
YR 2011
UL http://www.ajnr.org/content/32/4/759.abstract
AB BACKGROUND AND PURPOSE: The use of cerebral protection during CAS in the treatment of carotid artery disease is matter of controversy. The purpose of this study was to evaluate the outcome of CASWBAP in a large cohort of patients, with ≤7 years' follow-up. MATERIALS AND METHODS: Two hundred thirty-six patients with 255 symptomatic carotid stenoses and/or with high-risk-morphology plaques of >50% and asymptomatic plaques of >70% were prospectively identified. Patients underwent neurologic and carotid US examination before the procedure and during follow-up at 1, 3, 6, and 12 months and annually thereafter. Plain films of the neck were obtained immediately after the procedure and then at 1 and 3 months. RESULTS: Technical success was achieved in 253/255 (99%) patients. Primary stent placement was successful in 248/253 (98%) patients. Neurologic periprocedural complications within 30 days included 1 (0.4%) nondisabling stroke, 1 (0.4%) disabling stroke, 11 (4.3%) TIAs, and 1 (0.4%) death. The mean duration of follow-up was 23 ± 1.4 months (range, 3–84 months). During the follow-up period, there were 9 additional deaths (7 unrelated to the carotid disease and 2 stroke-related) and 2 strokes (in other vascular territories). The degree of stenosis decreased from a mean of 82% before the procedure to a mean of 30% immediately after. During follow-up, 38 (14.8%) angioplasties were performed due to restenosis in 19 (7.4%) patients, lack of stent expansion in 14 (5.4%), or both in 5 (1.9%). CONCLUSIONS: CASWBAP is effective and safe with a low incidence of periprocedural complications, providing satisfactory long-term clinical results. CAScarotid artery stentingCASWBAPcarotid artery stenting without balloon angioplasty and protectionCEAcarotid endarterectomyCPDcerebral protection deviceCTACT angiographyDWIdiffusion-weighted imagingICUintensive care unitMRAMR angiographyNASCETNorth American Symptomatic Carotid Endarterectomy TrialTCDtranscranial Doppler sonographyTIAtransient ischemic attackUSultrasonography