Carotid artery stenting: a single-center experience

ABSTRACT

Carotid artery stenting is now used as an alternative to surgical endarterectomy. This study was done to assess the feasibility, safety, and immediate and late clinical outcomes in patients undergoing carotid stenting. Between July 2008 and December 2009, a total of 40 patients [20 male, mean age 65 +/- 11 years, 19 symptomatic, and 90% high risk for endarterectomy] underwent carotid artery stenting with different embolic protection devices and carotid stents. Thirty-seven patients had coronary artery disease. Technical success rate, stroke/death/ myocardial infarction rate at 30 days, access-site complications, and contrast-induced nephropathy were assessed. For the evaluation of the influence of experience in carotid artery stenting on complications, the patients were divided into two groups Group I included the first 20 treated patients and Group 2 comprised the remainder of the patients. The overall technical success rate was 100%. The cumulative in-hospital stroke death rate was 7.5% [n = 31 deaths and I major stroke]. Complications were more frequent in Group 1 [2/20, 10%; 2 deaths] than in Group 2 [1/20, 5%; 1 major stroke], but this was not statistically significant [p value = 0.09]. No access-site complications occurred, and mild contrast-induced nephropathy occurred in 3 patients [7.5%]. No major stroke or neurological deaths occurred during a mean follow-up of 12 months. Carotid stenting seemed feasible and relatively safe in our experience. Advanced experience in carotid artery stenting appears to confer an acceptable peri-procedural stroke-death rate