Carotid artery stenting for calcified lesions
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Updated: Jul 5, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
M Tsutsumi1, H Aikawa, M Onizuka
1Department of Neurosurgery and Neuroradiology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Insights
Carotid artery stenting (CAS) using embolic protection devices (EPDs) is feasible for treating calcified carotid artery lesions. This study demonstrates successful outcomes and no major complications in patients with severe stenosis and plaque calcification.
Area of Science:
- Interventional Cardiology
- Vascular Surgery
- Medical Imaging
Background:
- Severe carotid artery stenosis with plaque calcification poses challenges for intervention.
- Accurate assessment of plaque calcification is crucial for procedural planning.
Purpose of the Study:
- To evaluate the feasibility and safety of carotid artery stenting (CAS) in patients with calcified carotid artery lesions.
- To assess the impact of plaque calcification characteristics on CAS outcomes.
Main Methods:
- 51 CAS procedures were performed in 43 patients with severe carotid artery stenosis and calcified plaques.
- Multidetector-row CT was used to quantify the arc and volume of plaque calcification.
- Embolic protection devices (EPDs) were utilized during all stenting procedures.
Main Results:
- Mean arc of calcification was 201.1 degrees; mean calcification volume was 154.9 mm³.
- All 51 CAS procedures were technically successful with no major adverse events (stroke, death).
- A correlation was observed between the arc of calcification and residual stenosis, though excellent dilation was achieved in all cases.
Conclusions:
- Carotid artery stenting (CAS) using EPDs is a feasible and safe treatment option for severe carotid artery stenosis with significant plaque calcification.
- The procedure is effective even in cases with near-total circumferential calcification, achieving satisfactory luminal gain.
Background And Purpose:
Our aim was to assess the feasibility of carotid artery stent placement (CAS) for calcified lesions.
Materials And Methods:
Using embolic protection devices (EPDs), we performed 51 CAS procedures in 43 patients with severe carotid artery stenosis accompanied by plaque calcification. Before intervention, all lesions were subjected to multidetector-row CT. The arc of the circumferential plaque calcification was measured on axial source images at the site of maximal luminal stenosis, and the total volume of the plaque calcification was determined. The angiographic outcome immediately after CAS, and intra- and postoperative complications were recorded.
Results:
The mean arc of calcification was 201.1 +/- 72.3 degrees (range, 76-352 degrees ), and the mean of the total calcification volume was 154.9 +/- 35.4 mm(3) (range, 92-2680 mm(3)). Balloon rupture occurred in 1 procedure (2.0%) at predilation angioplasty; all 51 CAS procedures were successful without clinical adverse effects. Although there was a correlation between the arc of plaque calcification and residual stenosis (r = 0.6, P < .001), excellent dilation with residual stenosis < or =30% was achieved in all lesions. There was no correlation between the total volume of calcification and residual stenosis. None of the patients developed stroke or death within 30 days of the CAS procedure.
Conclusion:
CAS by using EPDs to treat lesions with plaque calcification is feasible even in patients with near-total circumferential plaque calcification.
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