Immediate and long-term results of carotid artery stenting

Abstract

Was analyzed the outcome of carotid artery stenting done for de-novo carotid stenosis in 190 patients (84 asymptomatic, 106 symptomatic), focusing on pre-procedural management and pharmacologic support of the intervention. Self-expanding stents «Precise PRO RX» and «Protégé RX» were implanted in all cases, the use of distal embolic protection device was mandatory. All procedures were performed by well-trained specialists, who had extensively practiced interventions on cerebral vasculature. Stenting procedure was uneventful in nearly all patients. A minor stroke occurred in two (n=2), another one (n=1) developed stent thrombosis. A total of 86 patients were followed-up during 2–15 years postoperatively. There were three (n=3) strokes during follow-up. On duplex ultrasound the stent was expanded completely in 70 patients, while 16 had <30% residual stenosis due to incomplete dilation of the stent. Of the 86 patients, 51 are socially active, including 30 who are employed. Therefore, carotid artery stenting had favorable immediate and long-term outcome in these patients. Early complications were diagnosed in 4 (2%) of 190 patients. At follow-up 3 of 86 (3,5%) patients developed stroke. These results particularly suggest that carotid artery stenting can be non-inferior to open repair when performed under precise pharmacologic support by a skilled team of specialists.

Keywords

carotid artery disease / carotid artery stenting / stenting outcome / revascularization / pharmacological support of stenting / carotid stents / endovasal interventions

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RIGHTS & PERMISSIONS

Krejl’ V.A., Azovcev R.A., Vavilov V.N., Tokarevich K.K., Lapina V.M., Kovalev V.A.