BackgroundRevascularization with carotid stent (CAS) is considered the therapeutic alternative to endarterectomy (CEA). However, its role compared to CEA remains questioned, mainly due of the heterogeneity of long-term results. The objective of this study was to report the efficacy and durability of CAS in terms of stroke prevention in a “real world experience”.MethodThis was a single-center retrospective analysis of 344 patients treated with CAS between January 2001 and December 2015.The primary outcome of the trial was stroke, myocardial infarction, or death during a periprocedural period or any stroke event over a 15-year follow-up. The secondary aim was to identify risk factors for 30-day complications, long-term neurological complications, and intra-stent restenosis.ResultsThe primary composite end point (any stroke, myocardial infarction, or death during the periprocedural period) was 2.3%. The use of an EPD was protective against major complications.Long-term follow-up was achieved in 294 patients (85,5%) with a median of 50 months (range 0-155 months). Fifty-six (16,3%) died within this period, most commonly of nonvascular causes (4 patients had stroke-related deaths). During the follow-up period, 8 strokes and 3 TIAs were diagnosed (3.2%).ISR determined by sequential ultrasound was assessed in 4.4% of the patients and remained asymptomatic in all but 2 patients (0.6%). All patients with restenosis underwent revascularization with balloon angioplasty.ConclusionThe long-term follow-up results of our study validate CAS as a safe and durable procedure with which to prevent ipsilateral stroke, with an acceptable rate of restenosis, recurrence and mortality.

We present a mucosal Schwann cell hamartoma that was observed in a 63-year-old woman with no personal or family history of interest who underwent a screening colonoscopy for early detection of colon cancer. During colonoscopy, a small polyp with a maximum diameter of 0.8 cm was detected at the rectosigmoid level. Histologically, a benign lesion of neuroid aspect was observed, consisting of multiple spindle cell fascicles that was positive for S-100 and negative for enolase, synaptophysin, CD34, CD117, actin, desmin, Dog1, EMA, and neurofilaments. These findings, supported by the family and personal history of the patient, allowed us to make a diagnosis, discarding other entities.