Document Detail


Carotid stenting in asymptomatic carotid stenosis: the Calgary experience.
MedLine Citation:
PMID:  21059500     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although carotid endarterectomy is considered the 'gold standard' for standard risk symptomatic patients, the treatment of choice for asymptomatic patients remains controversial. Carotid stenting has demonstrated real-world outcomes consistent with established guidelines for carotid endarterectomy in asymptomatic high-surgical risk patients in recent prospective multicenter trials. We describe our experience with asymptomatic patients who underwent carotid stenting at our center in a routine clinical setting.
METHODS: This is a retrospective, longitudinal cohort study of patients who underwent carotid angioplasty and stenting at the Foothills Medical Center, Calgary, Canada between 1997 and 2007. The qualifying events were categorized as symptomatic and asymptomatic. The procedures were performed by four experienced neurointerventionists. The primary outcome was stroke or death at 30-day follow- up.
RESULTS: 243 patients underwent 255 carotid stenting procedures. Their ages ranged from 50 to 83 years; the mean age was 72.0 ± 9.3 years; 67(26.3%) were women. Forty one patients (16.1%) were asymptomatic; 214 patients (83.9%) were symptomatic. The patients in the asymptomatic group were significantly younger - 66.0 ± 8.8 years compared to patients in the symptomatic group 73.2 ± 8.9 years (p < 0.0001). Intraprocedurally one minor stroke (2.4%) occurred in the asymptomatic group. At 30-day follow-up, no deaths or further strokes were noted in the asymptomatic group; while eight deaths, six major and seven minor strokes occurred in the symptomatic group (p = 0.22).
CONCLUSION: Carotid stenting appears to be a safe procedure in asymptomatic patients with severe carotid stenosis in routine clinical settings as witnessed in this single center study.
Authors:
N Shobha; M A Almekhlafi; A Pandya; P L Couillard; W F Morrish; J H Wong; M D Hill
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques     Volume:  37     ISSN:  0317-1671     ISO Abbreviation:  Can J Neurol Sci     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-11-09     Completed Date:  2010-12-10     Revised Date:  2011-04-07    
Medline Journal Info:
Nlm Unique ID:  0415227     Medline TA:  Can J Neurol Sci     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  568-73     Citation Subset:  IM    
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Canada / epidemiology
Carotid Stenosis / epidemiology*,  surgery*
Cohort Studies
Endarterectomy, Carotid / methods*
Female
Humans
Male
Middle Aged
Retrospective Studies
Risk Assessment
Risk Factors
Treatment Outcome
Comments/Corrections
Comment In:
Can J Neurol Sci. 2011 Mar;38(2):379

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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