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Six-year outcomes of carotid artery stenting performed with multidisciplinary management in a single center

Erkan Köklü1, Şakir Arslan1, Elif Sarıönder Gencer2

  • 1Department of Cardiology, University of Health Sciences, Antalya Training and Research Hospital; Antalya-Turkey.

Anatolian Journal of Cardiology
|June 8, 2021
PubMed

Insights

Carotid artery stenting (CAS) is a safe and effective treatment for both symptomatic and asymptomatic carotid artery stenosis, showing high success rates and acceptable complications in real-world data. This multidisciplinary approach ensures reliable outcomes for diverse patient groups.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Neurology

Background:

  • Carotid artery stenosis poses a significant risk for stroke.
  • Carotid artery stenting (CAS) is an alternative to endarterectomy.
  • Real-world data on CAS outcomes, including asymptomatic cranial embolism and restenosis, are crucial.

Purpose of the Study:

  • To evaluate the 30-day clinical outcomes of CAS.
  • To assess periprocedural asymptomatic cranial embolism.
  • To determine long-term restenosis rates after CAS in a real-world patient cohort.

Main Methods:

  • A consecutive series of 610 patients undergoing CAS between 2010 and 2019 were analyzed.
  • Patients were followed for a mean of 6 years, with stratification into symptomatic (45%) and asymptomatic (55%) groups.
  • Embolism protection devices were utilized in varying percentages (distal 52%, proximal 43%).

Main Results:

  • The CAS procedure achieved a 96% success rate with low procedure-related mortality (0.6%).
  • Clinical complication rates within 30 days were 1.6% in asymptomatic and 3.1% in symptomatic patients.
  • Cranial MRI revealed asymptomatic microembolism in 11.6% (ipsilateral) and 3.9% experienced asymptomatic restenosis.

Conclusions:

  • CAS is a reliable treatment for carotid artery stenosis, offering acceptable success and complication rates.
  • Multidisciplinary evaluation is key to successful CAS application, even in high-risk patients.
  • The procedure demonstrates efficacy in both symptomatic and asymptomatic individuals, aligning with established guidelines.
Abstract

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