Carotid artery stenting: analysis of data for 105 patients at high risk1 1Competition of interest: none
| Autor: | Ellie Chaktoura, Frank T. Padberg, Paul B. Haser, Jonathan Goldstein, Richard Kubicka, Brajesh K. Lal, Zafar Jamil, Joaquim J. Cerveira, Peter J. Pappas, Robert W. Hobson |
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| Rok vydání: | 2003 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Mortality rate Carotid endarterectomy medicine.disease Asymptomatic Surgery Stenosis Severity of illness medicine Myocardial infarction Radiology medicine.symptom business Cardiology and Cardiovascular Medicine Survival rate Stroke |
| Zdroj: | Journal of Vascular Surgery. 37(6):1234-1239 |
| ISSN: | 0741-5214 |
| DOI: | 10.1016/s0741-5214(02)75448-7 |
| Popis: | Objectives: Carotid artery stenting (CAS) has been recommended as an alternative to carotid endarterectomy (CEA) by some clinicians. However, recently published clinical trials have reported 30-day stroke and death rates of 10% to 12%. This prompted review of our experience with CAS in patients at high risk, to document our results and guide further use of CAS. Methods: From September 1996 to the present, we performed 114 consecutive CAS procedures in 105 patients. Sixty-three patients were men (60%) and 42 patients were women (40%), with mean age of 70 years (range, 45–93 years). Indications for CAS included recurrent stenosis after previous CEA in 74 patients (65%), primary lesions in 32 patients at high risk (28%), and carotid stenosis with previous ipsilateral radiation therapy in 8 patients (7%). Asymptomatic stenosis (>80%) was managed in 70 patients (61%), and symptomatic lesions (>50%) were treated in 44 patients (39%). Results: CAS was technically successful in all patients. Mean severity of stenosis before CAS was 87% ± 6%, compared with 9% ± 4% after CAS. Two patients (1.9%) died, 1 of reperfusion-intracerebral hemorrhage and 1 of myocardial infarction 10 days after discharge; and 1 patient (0.95%) had a stroke (retinal infarction), for a 30-day stroke and death rate of 2.85%. Two patients (1.9%) had transient neurologic events. No cranial nerve deficits were noted. No neurologic complications have been noted in the last 27 patients (26%). Conclusions: A 30-day stroke and death rate of 2.85% in our experience demonstrates acceptability of CAS as an alternative to repeat operation or primary CEA in patients at high risk or in patients with radiation-induced stenosis. We recommend further clinical investigation of CAS and participation in clinical trials by vascular surgeons. |
| Databáze: | OpenAIRE |
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