Global experience in cervical carotid artery stent placement

Area of Science:

• Interventional Cardiology
• Vascular Surgery
• Neurology

Background:

• Carotid artery atherosclerotic disease poses a significant risk for stroke.
• Surgical carotid endarterectomy is the traditional treatment but carries risks, particularly for high-risk patients.
• Endovascular stent placement has emerged as a less invasive alternative.

Purpose of the Study:

• To review and update the global status of carotid artery stent placement.
• To assess the safety and efficacy of carotid stenting procedures worldwide.
• To evaluate complications, including stroke and restenosis, associated with carotid stenting.

Main Methods:

• Global survey of major interventional centers across Europe, North America, South America, and Asia.
• Data collection on patient demographics, procedural techniques, and outcomes.
• Analysis of complications (transient ischemic attacks, minor/major strokes, death) and restenosis rates within 30 days and at 6-12 month follow-up.

Main Results:

• Over 5,210 procedures in 4,757 patients were reported globally.
• Technical success rate was high at 98.4%.
• Periprocedural complication rates: 2.82% TIAs, 2.72% minor strokes, 1.49% major strokes, and 0.86% mortality. Combined stroke and death rate was 5.07%.
• Restenosis rates were 1.99% at 6 months and 3.46% at 12 months.
• Neurologic event rate at 6-12 month follow-up was 1.42%.

Conclusions:

• Endovascular carotid stenting is an expanding alternative to vascular surgery for carotid artery disease.
• The procedure is particularly beneficial for patients at high risk for carotid endarterectomy.
• Periprocedural risks of stroke and death are generally acceptable in the current developmental stage and have remained stable.