Carotid artery stenting with routine cerebral protection in high-risk patients.

Peter H. Lin, Ruth L. Bush, Dieter F. Lubbe, Mitchell M. Cox, Wei Zhou, Sally A. McCoy, Deborah Felkai, Ramesh Paladugu, Alan B. Lumsden

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

BACKGROUND: Carotid artery stenting has emerged as an alternative treatment modality in carotid occlusive disease. This study examined our experience of carotid stenting with routine cerebral embolization protection in high-risk patients. METHODS: Clinical variables and treatment outcome of high-risk patients who underwent carotid stenting with neuroprotection were analyzed during a 26-month period. RESULTS: Sixty-eight high-risk patients with 72 carotid artery stenoses were treated. Procedural success was achieved in 70 cases (97%), and symptomatic lesions existed in 17 (24%) patients. Monorail Wallstents stents were used in all cases. Neuroprotective devices used were PercuSurge (28%) and Filterwire (72%). There was no periprocedural mortality or neuroprotective device-related complications. The 30-day stroke and death rate was 2.7%, and the overall complication rate was 6.9%. All stented vessels remained patent during the follow-up period (mean 15.3 +/- 4.2, range 1 to 23 months). Two asymptomatic in-stent restenosis (3%) occurred at 6 and 8 months, which were both successfully treated with balloon angioplasty. CONCLUSIONS: Our study showed that percutaneous carotid stenting with routine use of a cerebral protection device is a feasible and effective treatment in high-risk patients with carotid occlusive disease.

Original languageEnglish (US)
Pages (from-to)644-652
Number of pages9
JournalAmerican Journal of Surgery
Volume188
Issue number6
DOIs
StatePublished - Dec 2004

ASJC Scopus subject areas

  • Surgery

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