Document Detail

Eight-year experience with carotid artery stenting for correction of symptomatic and asymptomatic post-endarterectomy defects.
MedLine Citation:
PMID:  20801609     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Carotid endarterectomy (CEA) has been shown to be superior to medical therapy alone in the prevention of stroke only if it can be safely performed (ie, with a complication rate less than 3% in asymptomatic patients and less than 6% in symptomatic patients). Technical defects are the most common cause of neurological complications after CEA, and their correction has traditionally been performed through standard surgical techniques.
METHODS: From 1999, we started to treat intimal flaps, dissection, or partial thrombosis after CEA with carotid artery stenting (CAS). A retrospective analysis of the operating room registry and of the registry of our Interventional Cardiology laboratory was conducted in order to identify all the patients that underwent stenting of the internal carotid artery after CEA between January 2001 and June 2009.
RESULTS: During the time period considered, 5012 CEA were performed at our institution and a total of 34 patients (34/5012; 0.6%) were found to have received carotid stenting after CEA, both for symptomatic and asymptomatic defects. Immediate technical success was obtained in all patients. One major cerebrovascular adverse event (1/34; 3%) in the immediate perioperative period was recorded. At a mean follow-up of 18.6 months (range, 3-84 months; median, 12 months), we did not observe any neurological symptoms related to the treated carotid artery, nor hemodynamic in-stent restenosis. Long-term follow-up (ie, equal or greater than 4 years) was available for five patients: all patients remained event-free during the entire period.
CONCLUSIONS: Our study adds to the assumption that CAS in post-CEA symptomatic and asymptomatic patients is safe and technically feasible, and represents a valid and quick alternative to standard surgical revision. Even if in a small group of patients, long-term results seem promising.
Enrico Maria Marone; Giovanni Coppi; Yamume Tshomba; Roberto Chiesa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  52     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-14     Completed Date:  2011-04-06     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1511-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Vascular Surgery, Scientific Institute H. San Raffaele, Vita-Salute University School of Medicine, Via Olgettina 60, 20132 Milan, Italy.
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MeSH Terms
Aged, 80 and over
Carotid Artery, Internal / surgery*
Carotid Stenosis / surgery
Endarterectomy, Carotid / adverse effects*
Middle Aged

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