Clinical outcomes of severe calcified lesions after carotid artery stenting
10.3760/cma.j.cn113855-20210924-00569
- VernacularTitle:颈动脉硬化狭窄腔内治疗中钙化病变的处理与临床结局
- Author:
Xiao TANG
1
;
Hanfei TANG
;
Weiguo FU
;
Jianing YUE
;
Zhenyu SHI
;
Yi SI
;
Weimiao LI
;
Changpo LIN
;
Baolei GUO
;
Daqiao GUO
Author Information
1. 复旦大学附属中山医院血管外科 复旦大学血管外科研究所 国家放射与治疗临床医学研究中心，上海 200032
- Keywords:
Carotid stenosis;
Stent;
Calcification;
Ischemic stroke;
In-stent restenosis
- From:
Chinese Journal of General Surgery
2022;37(3):175-179
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety and efficacy of carotid artery stenting (CAS) in the treatment of non-circumferential severe calcification using the distal embolic protection device.Methods:Clinical data of patients with severe calcification lesions in cervical carotid artery treated by CAS from Jan 2018 to Dec 2020 at our center was analyzed retrospectively.Results:226 consecutively admitted patients of cervical carotid artery stenosis and non-circumferential severe calcification (CR>270°) underwent CAS using the distal embolic protection device. The technical success rate was 90.26%. No death or myocardial infarction occurred during the perioperative period. Two patients had ipsilateral hemiparesis ischemic stroke during post-dilatation. The incidence of perioperative bradycardia/hypotension was 25.34%. Patients were followed up for 6-36 months, with median follow-up period of 17.3 months. The incidence of mild or moderate in-stent restenosis (<70%) was 16.59%, and the incidence of severe in-stent restenosis or occlusion (>70%) was 3.22%.Conclusions:For carotid artery stenosis with non-circumferential severe calcification in high risk for CEA patients, carotid artery stenting is safe and effective with the aggressive pre-dilation strategies, strict stent selections and implantation standards. The incidence of perioperative death, myocardial infarction or ipsilateral hemiparesis ischemic stroke was low. The patency rate of the carotid stent in the calcification lesion is satisfactory during the mid-term follow-up.
