Follow-up Results of Stent Placement for Extracranial Carotid Artery Stenosis.
10.4070/kcj.1998.28.11.1820
- Author:
Young Sup YOON
;
Bum Kee HONG
;
Dong Hoon CHOI
;
Sun Ho KIM
;
Dong Ik KIM
;
Seung Min KIM
;
Yangsoo JANG
;
Won Heum SHIM
- Publication Type:Original Article
- Keywords:
Carotid arteries;
Stenosis,Stents;
Carotid endarterectomy
- MeSH:
Angiography;
Arteries;
Carotid Arteries*;
Carotid Stenosis*;
Cerebral Hemorrhage;
Congenital Abnormalities;
Constriction, Pathologic;
Coronary Artery Disease;
Endarterectomy;
Endarterectomy, Carotid;
Follow-Up Studies*;
Humans;
Incidence;
Male;
Neurologic Manifestations;
Stents*;
Stroke
- From:Korean Circulation Journal
1998;28(11):1820-1927
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: Carotid artery stenting has evolved as a potential alternative to carotid endarterectomy in patients (pts) with significant carotid artery stenosis. We evaluated the feasibility and long-term outcome of carotid artery stenting in selected pts at high surgical risk. MATERIALS AND METHODS: Between May, 1996 and September 1998 we performed carotid artery stenting at 35 lesions in 25 pts. There were 23 males and 2 fe-males. Mean age was 63.2+/-6.6 (range 54 - 77). Eight four percent (21/25) of the pts had significant coronary artery disease. Sixty four percent (16/25) of the pts had significant peripheral artery lesions. Sixty percent (15/25) of the pts had neurologic symptoms or non-disabling stroke. We used Wallstent in 32 lesions and Palmaz stent in 3 lesions. Carotid stenting was undertaken in 33 internal carotid, 1 common carotid and 1 external carotid lesions. Bil-ateral carotid stenting was undertaken in forty percent (10/25) of the pts. RESULTS: Carotid stenting was successful in all lesions. One patient died due to massive cerebral hemorrhage 3 days after carotid stenting, who had und-erwent stenting as a rescue procedure for failed endarterectomy. One major stroke developed during procedure with partial recovery. For the combined endpoint of strokes and death within 30 days of procedure, the incidence was 8% and 5.7% in terms of pts and procedures, respectively. On follow-up (12+/-7 months), we found neither neurologic complications nor death. Angiographic and/or duplex sonography which were performed at 5.5 month in all (18) eligible pts with 24 lesions revealed no evidence of stent deformity or restenosis ( 50% of diameter stenosis). Mean angiographic stenosis was 20% on follow-up angiography. CONCLUSION: Carotid artery stenting can be performed with high success and low complication rate in pts with significant carotid artery stenosis especially at high surgical risk. Follow-up clinical outcome of average 12 month was good with low restenosis rate.
