J Korean Surg Soc.  2011 Apr;80(4):283-288. 10.4174/jkss.2011.80.4.283.

The early and mid-term results of carotid artery stenting in high-risk patients

• Yun WS
• Kwun WH
• Suh BY

• KMID: 1820020
• DOI: http://doi.org/10.4174/jkss.2011.80.4.283

Abstract

PURPOSE
This study aimed to investigate early and mid-term outcomes of carotid artery stenting (CAS).
METHODS
We retrospectively reviewed 111 patients who were treated for carotid stenosis between October 2004 and December 2009 (42 CASs and 69 carotid endarterectomies [CEAs]).
RESULTS
CAS group was older than CEA group (70 years vs. 67 years, P = 0.001). Coronary artery disease and high lesion above the 2nd cervical vertebral body were more common in CAS group (29% vs. 13%, P = 0.002; 4% vs. 24%, P = 0.004). The 30-days stroke rate was higher in CAS group (10% vs. 1% in CEA group, P = 0.067, Fisher's exact test). New brain lesions on diffusion-weighted magnetic resonance imaging were more common in CAS group (48% vs. 20% in CEA group, P = 0.002, chi-square test). The 1-, 3-year freedom from stroke were 91%, 84% in CAS group and 99%, 99% in CEA group (P = 0.007, log-rank test). Univariate analysis showed that female gender and age > 70 years were related with postprocedural neurological complications (P = 0.046 and P = 0.007, log-rank test). However, none were independent risk factors on multivariate analysis.
CONCLUSION
In our series, the rates of peri-procedural neurological complications in CAS group were significantly high. These results suggest that more experience and restricted patient selection will be needed for CAS.

Keyword

Carotid artery stenosis; Stents; Endarterectomy; Stroke

MeSH Terms

Brain
Carotid Arteries
Carotid Stenosis
Coronary Artery Disease
Endarterectomy
Endarterectomy, Carotid
Female
Freedom
Humans
Magnetic Resonance Imaging
Patient Selection
Penicillanic Acid
Retrospective Studies
Risk Factors
Stents
Stroke
Penicillanic Acid

Figure

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  Fig. 1 Kaplan-Meier curves comparing freedom from ipsilateral stroke between the carotid artery stenting (CAS) and carotid endarterectomy (CEA) groups.

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  Fig. 2 Kaplan-Meier curves comparing freedom from restenosis between the carotid artery stenting (CAS) and carotid endarterectomy (CEA) groups.

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