Short- and long-term outcomes of angioplasty and stenting for high-risk extracranial carotid stenosis in carotid endarterectomy

• Main Authors: Kazemi-Saleh D, Karimi H, Saburi A, Niknam Z, Pishgoo B, Karimi P
• Format: Article
• Language: fas
• Published: Tehran University of Medical Sciences 2012-06-01
• Series: Tehran University Medical Journal
• Subjects: Angioplasty; carotid endarterectomy; carotid stenosis; stenting; stroke
• Online Access: http://tumj.tums.ac.ir/browse.php?a_code=A-10-25-133&slc_lang=en&sid=1
• ISSN: 1683-1764; 1735-7322

Background: Carotid endarterectomy (CEA) is a standard method for patient with significant carotid stenosis but direct surgical repair via carotid endarterectomy may not be a good option in some patients because of the overall health status that may make the surgery too risky. Carotid angioplasty and stenting (CAS), is a relatively new procedure for the treatment of carotid artery disease in patients who may not be fit enough to undergo surgery. In this investigation, we determined short- and long-term outcomes of stent angioplasty in high-risk patients for whom the risk of perioperative morbidity and mortality is high. Methods: We have followed 82 consecutive symptomatic patients with a ≥50% and asymptomatic patients with a ≥70%- 80% carotid stenosis within 15.9 months of angioplasty and stenting in Baqiyatallah and Jamaran hospitals from 2008-2010. All the patients were considered poor surgical candidates by experienced surgeons and anesthesiologists upon pre-surgical consultation. Results: This descriptive cross-sectional study was performed on 28 women and 54 men with a mean age of 69.7±9.2 years. The procedure was technically successful in 79 (96.3%) cases. There were 6 (7.3%) deaths, 5 (6.1%) strokes, 4 (4.9%) MIs and 4 (4.9%) TIAs during the follow-up period. Conclusion: The clinical results during the short available follow-up period suggested stent angioplasty to be useful, effective, reliable and safe in the treatment of significant cervical carotid stenosis in high-risk patients. Further analytical investigations with longer follow-up periods for predicting risk factors are recommended.