| High rate of restenosis after carotid artery stenting in patients with high-grade internal carotid artery stenosis. Medium-term follow-up. | |
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MedLine Citation:
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PMID: 18821044 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Carotid endarterectomy (CEA) is the gold-standard procedure for the majority of patients with high-grade symptomatic internal carotid artery stenosis and also for specified high-grade asymptomatic stenoses; however, a proportion of patients are treated with carotid endovascular therapy. We aimed to document medium-term clinical and neurosonographical outcome after carotid artery stenting (CAS). METHODS: 53 patients (mean age: 65 +/- 8 years) with high-grade (> or = 70 % by means of duplex sonography) carotid artery stenosis were enrolled into the study. Nineteen patients had asymptomatic, 34 patients had symptomatic stenoses. All patients had a pre-interventional CT, Doppler and duplex sonography, and digital subtraction angiography (DSA) or magnetic resonance angiography (MRA) prior to the procedural DSA. All patients were offered CEA as the gold-standard procedure and as an alternative to CAS. Both clinical and Duplex sonographical follow-up was obtained at day 1 and 7, month 1, month 3, month 6, month 12, and every subsequent 6 months after the procedure. Mean follow-up time was 22 +/- 1.6 months (+/- SEM). RESULTS: 2/53 patients suffered from stroke. A further 2 patients suffered from carotid artery occlusion shortly after CAS. The cumulative rate of restenosis during follow-up was 24.5 % (13/53). Four of these (7.5 %) were of high-grade and led to further interventional or surgical therapy. CONCLUSIONS: A high rate of restenosis was found during follow-up after CAS. Our analysis of non-selected patients emphasizes that CEA remains the gold-standard procedure for the treatment of symptomatic internal carotid artery stenosis. The frequently performed endovascular treatment of carotid stenosis outside the setting of a randomized controlled trial is not supported by our data. |
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Authors:
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Judith U Harrer; Ralf Morschel; Michael Mull; Christoph M Kosinski |
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Publication Detail:
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Type: Clinical Trial; Journal Article Date: 2008-09-24 |
Journal Detail:
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Title: Journal of neurology Volume: 255 ISSN: 0340-5354 ISO Abbreviation: J. Neurol. Publication Date: 2008 Sep |
Date Detail:
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Created Date: 2008-10-29 Completed Date: 2009-02-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0423161 Medline TA: J Neurol Country: Germany |
Other Details:
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Languages: eng Pagination: 1309-14 Citation Subset: IM |
Affiliation:
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Neurological Clinic, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany. Judith.Harrer@web.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Balloon / adverse effects, methods* Carotid Artery, Internal / radiography, surgery*, ultrasonography Carotid Stenosis / pathology, surgery* Endarterectomy, Carotid / adverse effects, methods* Female Follow-Up Studies Humans Magnetic Resonance Angiography / methods Male Middle Aged Postoperative Complications / diagnosis Recurrence Risk Factors Severity of Illness Index Stents* Survival Analysis Time Factors Tomography, X-Ray Computed / methods Treatment Outcome Ultrasonography, Doppler, Duplex / methods |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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