Percutaneous transluminal stenting in patients with carotid artery stenosis

To assess the efficacy and safety of percutaneous transluminal stenting for patients with carotid artery stenosis.

Selective percutaneous transluminal stenting was performed for patients with symptomatic carotid artery stenosis (luminal narrowing > or = 70%). Success rates and complications associated with the procedures were observed. During six months of follow-up, both recurrent symptom and restenosis rates were recorded.

There were 17 bifurcating lesions among 27 stenoses in 26 patients, of whom 18 had concomitant coronary artery diseases. The acute procedural success rate was 96.3% (26/27), and the degree of stenosis was reduced from 88.6% +/- 8.9% (range 70-100) to 0.4% +/- 2.0% (range 0-10). Six patients developed severe bradycardia and hypotension, and 3 experienced transient loss of consciousness during balloon dilatation. During hospitalization, 2 patients experienced loss of consciousness and convulsion, respectively, due to hyperperfusion, and both recovered 12 hours later. There were 2 minor stroke cases (7.4%) but no cases of major stroke or death. At the 6-month follow-up, there were no cases of TIA or new onset of stroke. There was no restenosis detected in 16 cases using angiography and in 10 cases using MRI in 6 to 16 months of follow-up.

Percutaneous transluminal stenting for patients with carotid artery stenosis has a high procedural success rate with few and acceptable complications. Few patients suffered from recurrent symptoms or showed restenosis in long-term follow-up.