Ischemic complications after tailored carotid artery stenting in different subpopulations with high-grade stenosis: Feared but rare

Publication date: Available online 28 November 2014 Source:Journal of Clinical Neuroscience Author(s): José E. Cohen , J. Moshe Gomori , Eyal Itshayek , Stylianos Pikis , Galina Keigler , Roni Eichel , Ronen R. Leker Although the procedural and postoperative safety profile of carotid artery stenting (CAS) has been steadily improving, many centers still recommend carotid endarectomy (CEA) over CAS. We assessed outcomes (procedural and postoperative stroke) following tailored CAS in a cohort of patients managed at a single academic medical center. Outcomes for patients with carotid artery stenosis treated from 2005–2013 with CAS were retrospectively reviewed. Stenosis was assessed with Doppler ultrasonography and/or CT angiogram, and angiography. Symptomatic and asymptomatic patients were dichotomized (based on the North American Symptomatic Carotid Endarterectomy Trial [NASCET] and the Asymptomatic Carotid Atherosclerosis Study [ACAS]). CAS technique was chosen based on angiographic and clinical characteristics; procedures were performed with/without pre-angioplasty, cerebral protection, and post-dilation. Endpoints were cumulative incidence of ipsilateral stroke, myocardial infarction, and death within 30days (primary) or 12months (secondary). Overall 249 patients (151 men/98 women; mean age 69.9years) with 254 carotid stenoses were included; 148 lesions (58%) were asymptomatic, and 106 (42%) were symptomatic. CAS was successfully performed in all lesions. At 30...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research