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Eight-year experience with carotid artery stenting for correction of symptomatic and asymptomatic post-endarterectomy defects
- Publication Year :
- 2010
-
Abstract
- Background: Carotid endarterectomy (CEA) has been shown to be superior to medical therapy alone in the prevention of stroke only if it can be safely performed (ie, with a complication rate less than 3% in asymptomatic patients and less than 6% in symptomatic patients). Technical defects are the most common cause of neurological complications after CEA, and their correction has traditionally been performed through standard surgical techniques. Methods: From 1999, we started to treat intimal flaps, dissection, or partial thrombosis after CEA with carotid artery stenting (CAS). A retrospective analysis of the operating room registry and of the registry of our Interventional Cardiology laboratory was conducted in order to identify all the patients that underwent stenting of the internal carotid artery after CEA between January 2001 and June 2009. Results: During the time period considered, 5012 CEA were performed at our institution and a total of 34 patients (34/5012; 0.6%) were found to have received carotid stenting after CEA, both for symptomatic and asymptomatic defects. Immediate technical success was obtained in all patients. One major cerebrovascular adverse event (1/34; 3%) in the immediate perioperative period was recorded. At a mean follow-up of 18.6 months (range, 3-84 months; median, 12 months), we did not observe any neurological symptoms related to the treated carotid artery, nor hemodynamic in-stent restenosis. Long-term follow-up (ie, equal or greater than 4 years) was available for five patients: all patients remained event-free during the entire period. Conclusions: Our study adds to the assumption that CAS in post-CEA symptomatic and asymptomatic patients is safe and technically feasible, and represents a valid and quick alternative to standard surgical revision. Even if in a small group of patients, long-term results seem promising. (J Vase Surg 2010;52:1511-7.)
- Subjects :
- Adult
Male
Reoperation
medicine.medical_specialty
medicine.medical_treatment
Carotid endarterectomy
Asymptomatic
medicine.artery
medicine
Humans
Carotid Stenosis
Stroke
Endarterectomy
Aged
Aged, 80 and over
Endarterectomy, Carotid
Interventional cardiology
business.industry
Perioperative
Middle Aged
medicine.disease
Surgery
Female
Stents
Radiology
Internal carotid artery
Carotid stenting
medicine.symptom
business
Cardiology and Cardiovascular Medicine
Carotid Artery, Internal
Subjects
Details
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....5e34ca6e5b56cf31921f3f16e290643c