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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Carotid stent-assisted angioplasty
1Department of Internal Medicine, Tygerberg Hospital, W. Cape.
Insights
Carotid stent-assisted angioplasty is a safe and effective treatment for carotid artery stenosis. This study shows high success rates with minimal complications, offering a valuable alternative for selected patients.
Area of Science:
- Cardiovascular Surgery
- Interventional Neurology
- Vascular Medicine
Background:
- Carotid artery stenosis poses a significant risk of stroke.
- Surgical endarterectomy has been the traditional treatment.
- Minimally invasive endovascular techniques are emerging.
Purpose of the Study:
- To evaluate the safety and efficacy of carotid stent-assisted angioplasty.
- To report outcomes in the first 33 patients treated at Panorama Medi-Clinic.
- To assess short-term and mid-term results of this interventional procedure.
Main Methods:
- Retrospective analysis of 33 patients undergoing carotid stent-assisted angioplasty (March 1995 - June 1996).
- Deployment of Palmaz-Schatz and Wall stents in common and internal carotid arteries for >60% stenosis.
- Follow-up included clinical evaluation, duplex scanning, and cerebral MRI over 15 months.
Main Results:
- 100% angiographic success (residual stenosis <10%).
- 97.7% clinical success (no death, stroke, or TIA in-hospital).
- Low complication rate: one stroke, two cerebellar infarcts; no TIAs or deaths; no restenosis observed.
Conclusions:
- Carotid stent-assisted angioplasty is a highly effective endovascular treatment for carotid stenosis.
- It offers a safe alternative to surgery for selected patients.
- This technique shows promising results with no observed restenosis in the follow-up period.
Abstract:
We present the results of the first 33 patients who underwent carotid stent-assisted angioplasty at the Heart Unit of Panorama Medi-Clinic between March 1995 and June 1996. Intravascular stents (48 Palmaz-Schatz and 1 Wall stent) were deployed in the common carotid arteries (5) and internal carotid arteries (38) of both symptomatic (28 patients) and asymptomatic patients (5 patients) with > 60% stenosis (35 with > 70% and 6 with 60% stenosis). Thirteen patients underwent bilateral stent implantation, and had percutaneous transluminal coronary angioplasty or a peripheral and/or coronary stent implanted. Mean admission time was 2 days. Follow-up for 15 months (mean 9 months) employed clinical evaluation, duplex scanning at 6 and 12 months, and cerebral magnetic resonance imaging before, 48 hours and 6 months after the procedure. Angiographic success, defined as maximal residual stenosis < 10%, was achieved in 100%. Clinical success, defined as maximal residual stenosis < 10% and absence of death or recurrent transient ischaemic attack or stroke in hospital, was achieved in 97.7% of treated lesions. Complications included one procedure-related ipsilateral stroke and two angiography-related cerebellar infarcts. No transient ischaemic attacks or deaths occurred. No early or late restenoses have been observed to date. This experience with carotid stent-assisted angioplasty indicates that interventional neurovascular therapies may provide a useful alternative for selected patients requiring endoluminal reconstruction of carotid stenoses.
