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Updated: Aug 15, 2025
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
The Safety and Long-Term Efficacy of Carotid Artery Stenting: An All-Comers Registry
Ratheesh Kumar1, Davinder Chadha2, Amitoj Chaddha3
1Cardiology, Army Hospital Research and Referral, New Delhi, IND.
Insights
Carotid artery stenting (CAS) is a safe and effective procedure for preventing strokes in patients with carotid artery stenosis. Real-world data shows CAS is equally effective as other methods, with outcomes worsening with increased patient age.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Neurology
Background:
- Carotid artery stenting (CAS) offers a less invasive alternative to carotid endarterectomy (CEA).
- Limited real-world data exists comparing CAS and CEA outcomes.
- Tertiary care centers provide valuable insights into clinical practice.
Purpose of the Study:
- To evaluate the real-world safety and effectiveness of CAS.
- To assess the primary composite outcome of periprocedural MACCEs and long-term ipsilateral stroke.
- To determine the rate of restenosis after CAS.
Main Methods:
- Prospective observational study of 115 patients undergoing CAS (2007-2019).
- Follow-up for a median of 80.5 months, assessing periprocedural events and long-term outcomes.
- Primary outcome: composite of MACCEs (30-day) and ipsilateral stroke; Secondary outcome: restenosis.
Main Results:
- The primary composite outcome occurred in 8.7% of patients (10/115).
- Higher age was significantly associated with the primary composite outcome (p=0.005).
- Restenosis occurred in 3.48% of patients; 4.34% were lost to follow-up.
Conclusions:
- CAS is a safe and effective intervention for significant carotid artery stenosis.
- CAS demonstrates comparable effectiveness to other methods in preventing future strokes.
- Increased patient age is a risk factor for adverse outcomes following CAS.
Abstract:
Background Carotid artery stenting (CAS) has emerged as a less invasive alternative to carotid endarterectomy (CEA) for the prevention of future cerebrovascular events in patients with carotid artery stenosis. Despite multiple randomized controlled trials (RCTs) comparing CAS and CEA for carotid disease, real-world data outside the rigorous environment of trials is scarce. Methods The present study is a prospective observational study conducted at a tertiary care center, wherein all patients who underwent CAS between January 2007 and December 2019 were included. All patients were followed up for one year of the last enrolled patient at an interval of one, six, and 12 months and then yearly thereafter. The primary composite outcome was defined as a combination of periprocedural (until 30 days of procedure) major adverse cardiac and cerebrovascular events (MACCEs) and the long-term incidence of ipsilateral stroke. The secondary outcome included the rate of restenosis. Results A total of 115 patients (86 males and 29 females) (147 lesions) who underwent CAS between 2007 and 2019 were followed up for a median of 80.5 months. Seventy-seven (67.27%) patients were symptomatic, and 38/115 (33%) were asymptomatic. Periprocedural MACCEs were noted in six patients, and four patients had ipsilateral stroke on long-term follow-up; hence, the primary composite outcome was observed in 10 (8.7%) patients. Higher age was found to be significantly associated with the primary composite outcome (p-value = 0.005). Five (4.34%) patients were lost to follow-up, while four (3.48%) patients developed restenosis. Conclusion CAS is a safe and less invasive intervention in patients with significant carotid artery stenosis and is equally effective in preventing future strokes. The incidence of primary outcome rises with an increase in age.
