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Endovascular stents for carotid artery occlusive disease Wholey MH; Wholey MH; Jarmolowski CR; Eles G; Levy D; Buecthel JJ Endovasc Surg 1997[Nov]; 4 (4): 326-38PURPOSE: To study the feasibility and safety of endovascular stenting of cervical carotid artery stenosis. METHODS: Between April 1994 and May 1997, 108 consecutive patients (58 men; mean age 70.1 years) with > or = 70% carotid stenosis were treated with percutaneous stent implantation under a protocol that featured independent neurological review. Forty-four percent were asymptomatic. Over half the lesions (59%) were in the internal carotid artery; the mean stenosis was 86%. Palmaz stents were implanted without cerebral protection following preliminary balloon dilation; two Wallstents were used in long lesions. RESULTS: Carotid stents were successfully placed in 108 of 114 (95%) lesions. Of the 6 technical failures, 5 were access related and 1 was due to seizures during balloon dilation. Two major (1.8%) and 2 minor (1.8%) strokes occurred (3.7% stroke rate for 108 patients; 3.5% in 114 procedures), all in symptomatic patients, one of whom died. There were 5 (4.4%) transient ischemic attacks and 2 (1.8%) brief seizure episodes during dilation. One patient died of a cardiac event on day 20. The all stroke or death rate was 5.3% based on 114 arteries at risk (5.6% in 108 patients). In the mean 6-month follow-up (range 1 to 36) of 97 eligible patients, 3 (3.1%) died from unrelated causes. There was 1 restenosis (1.0%) from a stent compression, which was successfully redilated. There were no neurological sequelae, cranial palsies, or cases of stent or vessel thrombosis in follow-up. CONCLUSIONS: The use of stents in the treatment of cervical carotid occlusive disease appears feasible, effective in the short term, and without excessive risk of periprocedural stroke.|*Stents[MESH]|Adult[MESH]|Aged[MESH]|Aged, 80 and over[MESH]|Carotid Stenosis/complications/mortality/*surgery[MESH]|Catheterization[MESH]|Cerebral Angiography[MESH]|Cerebrovascular Disorders/etiology/mortality/prevention & control[MESH]|Endarterectomy, Carotid[MESH]|Female[MESH]|Humans[MESH]|Male[MESH]|Middle Aged[MESH]|Minimally Invasive Surgical Procedures[MESH]|Postoperative Complications[MESH]|Prospective Studies[MESH]|Risk Factors[MESH]|Treatment Outcome[MESH] |
