Outcomes of carotid artery stenting for severe carotid stenosis in patients with contralateral occlusion / 中华普通外科杂志

ABSTRACT

Objective To analyze the perioperative mortality,stroke rates and late benefits of carotid artery stenting for the treatment of unilateral severe stenosis of carotid artery with contralateral obliteration in a single medical center.Methods Clinical data of 38 cases were analyzed retrospectively,including postoperative period and follow-up.Results The technical success rate was 100％ ( 38/38 )with no peri-operative 30-day mortality or ischemic stroke.The overall peri-operative complication rate was 34.2％ ( 13/38),including transient ischemic attack (TIA) in 5.3％ (2/38).The average follow-up time was ( 29 ± 13 ) months with follow-up rate of 86.8％ ( 33/38 ).The mortality was 0 and the overall complication rate was 12.1％ (4/33),including TIA in 6.1％ (2/33).No patients had recurrent stroke.Twenty-three cases underwent whole brain CT perfusion evaluation before and after the therapy.A significant improvement of the perfusion parameters was observed in the stenotic side after CAS.Conclusions CAS contralateral to an occluded carotid artery can be performed with acceptable perioperative mortality and stroke risk rates,as well as a satisfactory long-term beneficial effect in stroke prevention.