[Beyond coronary artery disease: interventional approach to carotid occlusive disease]
Augusto Farina1, Angelo Spinazzola, Giorgia Abbiati
1U.O. di Chirurgia Vascolare, A.O. Ospedale Maggiore, Crema (CR). a.farina@hcrema.it
Background:
The aim of the study was to report a single-center experience about early and mid-term complications in carotid artery stenting.
Methods:
From June 2005 to April 2009, 148 significant carotid artery stenoses were treated with carotid artery stenting in 140 patients. Preprocedural evaluation was performed with Duplex scan, angio-computed tomography scan or magnetic resonance imaging. Low-profile material was used with curves dedicated to bovine arch. Dual antiplatelet therapy was administered to all patients before and after the procedure.
Results:
Technical success was achieved in 144 procedures. Four patients (2.7%) required surgical conversion. The rate of neurological complications was 2% at 30 days (0.6% major stroke and 1.3% minor stroke/ transient ischemic attack). After 3 years of follow-up, 2 cases of restenosis occurred (1.3%), one of them necessitating endovascular reintervention.
Conclusions:
Data from our retrospective experience show that carotid artery stenting is a safe and effective procedure with technical results similar to those of surgery. Neurological complications represent a serious problem and their incidence rate is hard to reduce. At 3-year follow-up, the restenosis rate was low.
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