1. European registry of carotid artery stenting: Results from a prospective registry of eight high volume EUROPEAN institutions
- Author
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Pallav Garg, Gianmarco de Donato, Giambattista Parlani, Alberto Cremonesi, Paolo Rubino, Dimitry Nikas, Carlo Setacci, Horst Sievert, Eugenio Stabile, Martin Werner, Marc Bosiers, Fausto Castriota, Marius Hornung, Piergiorgio Cao, Laura Mauri, Andrej Schmidt, Patrick Peeters, Bernhard Reimers, Stabile, Eugenio, Pallav, Garg, Alberto, Cremonesi, Marc, Bosier, Bernhard, Reimer, Carlo, Setacci, Piergiorgio, Cao, Andrej, Schmidt, Horst, Sievert, Patrick, Peeter, Dimitry, Nika, Martin, Werner, Gianmarco de, Donato, Giambattista, Parlani, Fausto, Castriota, Marius, Hornung, Laura, Mauri, and Paolo, Rubino
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Carotid endarterectomy ,Revascularization ,Risk Assessment ,Severity of Illness Index ,Risk Factors ,Carotid artery disease ,medicine ,Humans ,Carotid Stenosis ,Radiology, Nuclear Medicine and imaging ,Hospital Mortality ,Prospective Studies ,Registries ,Adverse effect ,Stroke ,Aged ,Aged, 80 and over ,business.industry ,Incidence ,Mortality rate ,Angioplasty ,Percutaneous coronary intervention ,General Medicine ,medicine.disease ,Surgery ,Europe ,Clinical trial ,Treatment Outcome ,Female ,Stents ,Cardiology and Cardiovascular Medicine ,business ,Hospitals, High-Volume - Abstract
Background Carotid endarterectomy (CEA) is the standard revascularization therapy to prevent stroke in patients with carotid artery disease. Carotid artery stenting (CAS) could be considered a potential alternative in patients at high surgical risk. Recent clinical trials have challenged this concept due a relatively high incidence of post-CAS adverse events, which occurred in low volume centers. The aim of this study was to evaluate the outcomes associated with neuroprotected CAS in selected high volume centers. Methods From January 2007 to December 2007, 1,611 patients underwent neuroprotected CAS in eight European Centers. For each patients, clinical, procedural, and one month follow-up data from all patients have been collected. An independent clinical events committee adjudicated the events. Results Overall in hospital death was 0.06% (one patient), whereas in-hospital stroke was 0.49% (eight patients). Between hospital discharge and 30 days three additional patients died (0.18%) and 10 patients experienced a stroke (0.67%). Overall 30 days mortality was 0.24% (four patients) and stroke incidence 1.12% (18 patients). The 30 day stroke/death rate was 1.36%. Conclusions CAS is a reasonable alternative to CEA to treat carotid artery atherosclerosis in well-experienced high volume centers. These data suggest that future prospective trials comparing CAS and CEA outcomes should include only centers highly experienced in both treatment modalities. © 2012 Wiley Periodicals, Inc.
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- 2012
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