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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Early outcomes of carotid artery stenting
N Akar Bayram1, E Bozkurt, H Ayhan
1Cardiology Clinics, Ankara Atatürk Education and Research Hospital, Ankara, Turkey. drnihkar@yahoo.co.uk
Insights
Carotid artery stenting (CAS) is a safe alternative to carotid endarterectomy (CEA) for preventing stroke. Early outcomes show no major complications, with minimal transient symptoms in patients undergoing CAS.
Area of Science:
- Vascular Surgery
- Neurology
- Interventional Cardiology
Background:
- Ischemic cerebrovascular events are a leading cause of disability and mortality.
- Carotid artery stenting (CAS) is emerging as a viable alternative to carotid endarterectomy (CEA).
- This study evaluates the early outcomes and feasibility of CAS.
Purpose of the Study:
- To report early outcomes of patients treated with CAS.
- To discuss the practicability, advantages, and safety of CAS.
- To assess the efficacy of CAS in preventing cerebrovascular events.
Main Methods:
- Eighty patients underwent CAS between December 2009 and May 2011.
- Patients received self-expandable hybrid stents with either distal embolic protection (Angioguard®) or proximal blockage (Mo.MA®).
- Post-dilatation was performed after stent implantation.
Main Results:
- No strokes, myocardial infarctions, or deaths occurred during hospitalization.
- Follow-up of 10 months revealed no mortality, stroke, TIA, or myocardial infarction.
- No restenosis was observed on follow-up carotid Doppler ultrasonography.
Conclusions:
- CAS demonstrated a very low complication rate in this early follow-up period.
- Transient numbness and weakness occurred in 2.5% of patients without leading to morbidity.
- CAS is recommended as an alternative to CEA for revascularization, emphasizing center experience and patient selection.
Background And Aim:
Ischemic cerebrovascular events are the most common reason for patients to be bedridden and the third most common reason for death. Many studies in recent years have demonstrated that carotid artery stenting (CAS) may be an alternative to carotid endarterectomy (CEA). In this study, we aimed to report early outcomes of patients who were treated with CAS in our clinic and discuss practicability, advantages and safety of CAS.
Methods And Findings:
Eighty patients who underwent CAS between December 2009 and May 2011 were eligible. The mean age was 65 years (range, 49 - 89 years). Of the study group, 73.75% were males and 26.25% were female. The percentage of asymptomatic patients was 11.7%, and the remaining patients were symptomatic. A distal embolic protection device (Angioguard®) was used in 22% of the patients whereas, in the other patients (78%), a proximal blockage system (Mo.MA®) was used. Self-expandable hybrid stents were implanted in all patients and post-dilatation was performed after implantation. None of the patients suffered from stroke, myocardial infarction or death due to CAS during their hospital stay. The mean follow-up period was 10 months (range 2 - 18 months) after discharge. None of the patients had died or had a stroke, a transient ischemic attack (TIA), or a myocardial infarction during the follow-up period. Re-stenosis was not observed in the follow-up carotid Doppler ultrasonography; flow rates were within normal limits.
Conclusion:
No major complication was observed during the early follow-up period in patients who underwent CAS in our clinic. Only 2 (2.5%) patients showed transient numbness and weakness and these did not lead to morbidity. In the management guide of extracranial carotid and vertebral artery diseases, CAS, in the light of recent studies, is recommended as an alternative to CEA in recommendations for revascularization. One of the important issues emphasized in this guide is the experience of centers. Very low complication rates after CAS suggested that, with suitable patient selection and an experienced team, similar results may be obtained.