Carotid artery stenting without using any embolic protective device A single Centre experience

Area of Science:

• Neurology
• Vascular Surgery
• Interventional Cardiology

Background:

• Carotid artery stenting is a procedure to treat carotid stenosis, a major cause of stroke.
• Embolic protective devices (EPDs) are commonly used during stenting to prevent neurological complications.
• However, stenting is sometimes performed without EPDs.

Purpose of the Study:

• To evaluate the clinical outcomes of carotid artery stenting performed without cerebral embolism protective devices.

Main Methods:

• A retrospective review of 171 patients who underwent carotid stenting between 2014 and 2017.
• Patients had symptomatic >50% or asymptomatic >60% carotid artery narrowing.
• Outcomes were assessed based on neurological events, bleeding, and other complications within 24 hours post-procedure.

Main Results:

• 10 (5.8%) patients experienced an ipsilateral middle cerebral artery branch infarct.
• 5 (2.9%) patients had transient encephalopathy and agitation.
• Headache (31%) and hypotension (4.6%) were also observed; one patient (0.5%) died from rectus abdominis bleeding.

Conclusions:

• Carotid revascularization is crucial for preventing stroke in symptomatic or severe stenosis.
• Satisfactory results can be achieved without EPDs through careful patient selection and a multidisciplinary approach in experienced centers.