Document Detail

Does a contralateral carotid occlusion adversely impact carotid artery stenting outcomes?
MedLine Citation:
PMID:  21963325     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Carotid artery stenting (CAS) has grown as a possible alternative for the treatment of extracranial cerebrovascular disease in the past decade. A preexisting contralateral carotid artery occlusion has been described as a risk factor for inferior outcomes after carotid endarterectomy, but its impact on CAS outcomes is less understood.
METHODS: A retrospective review of 417 CAS procedures performed between May 2001 and July 2010 at a single center using self-expanding nitinol stents and mechanical embolic protection devices was conducted. Patients were divided into two groups, those with a preexisting contralateral carotid occlusion (group A, n = 39) versus those without a contralateral occlusion (group B, n = 378). Patient demographics and comorbidities as well as 30-day and late death, stroke, and myocardial infarction (MI) rates were analyzed. Mean follow-up was 4 years (range: 0-9.4 years).
RESULTS: Overall, mean age of the 314 men and 103 women was 70.5 years. In group A, there were two (5.1%) octogenarians and nine patients (23.1%) with symptomatic disease as compared with group B with 53 (14%) octogenarians and 121 (32%) patients with symptomatic disease. The overall 30-day death, stroke, and MI rates were 0.5%, 1.9%, and 0.7%, respectively. When comparing group A with group B, these results were not significantly different: death (0% vs. 0.5%), stroke (2.6% vs. 1.9%), and MI (0% vs. 0.8%). Long-term outcomes for groups A and B were also not significantly different: death (25.6% vs. 22.2%), stroke (5.3% vs. 3.4%), and MI (15.4% vs. 14%) (p = nonsignificant).
CONCLUSION: A preexisting contralateral carotid artery occlusion does not seem to adversely impact CAS outcomes.
Mark L Keldahl; Michael S Park; Manuel Garcia-Toca; Chih-Hsiung E Wang; Melina R Kibbe; Heron E Rodriguez; Mark D Morasch; Mark K Eskandari
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2011-10-01
Journal Detail:
Title:  Annals of vascular surgery     Volume:  26     ISSN:  1615-5947     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-19     Completed Date:  2012-05-08     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  40-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.
Division of Vascular Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
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MeSH Terms
Blood Vessel Prosthesis Implantation / adverse effects*
Carotid Stenosis / complications,  diagnosis,  surgery*
Follow-Up Studies
Neural Tube Defects
Postoperative Complications
Retrospective Studies
Risk Factors
Stroke / epidemiology*,  etiology
Survival Rate / trends
Time Factors
Treatment Outcome
Ultrasonography, Doppler, Duplex
United States / epidemiology
Grant Support
Reg. No./Substance:
0/Alloys; 52013-44-2/nitinol

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