Complication rate in unprotected carotid artery stenting with closed-cell stents

Abstract

Our clinical outcome demonstrates that unprotected CAS with small cell designed stents results in a very low procedural complication rate, which makes the use of a protection device dispensable.

Unprotected Carotid Artery Stenting in Symptomatic Patients with High-Grade Stenosis: Results and Long-Term Follow-Up in a Single-Center Experience

“…These reports included symptomatic and asymptomatic patients, with an average degree of stenosis ranging from 80% to 82%. [12][13][14][15] In our series, all cases were symptomatic except 9, and the mean degree of stenosis was 89%. In addition, our report included the largest number of symptomatic patients and the highest degree of stenosis.…”

“…The need for predilation is variable according to reports (2%-46%), [11][12][13] suggesting that it depends heavily on the experience and methodology of the operator. According to our experience, it is possible to navigate with the stent device system without predilation in most cases.…”

“…10 On the other hand, several uncontrolled reports have shown excellent results in patients treated by unprotected stent placement techniques. [11][12][13][14][15] We performed a study to assess the safety and efficacy of unprotected CAS. The aim of this study was to establish the cumulative incidence of stroke, death, or myocardial infarction within 30 days after the procedure and at 1-year follow-up.…”

Cerebral Hyperperfusion Syndrome After Angioplasty

“…Regarding prior stroke as a risk factor for CHS, many authors have found that diseases like diabetes mellitus or longstanding pre-existing hypertension in which microangiopathy affects the endothelium of small vessels predispose to hyperperfusion and CHS (Chamorro et al, 2000;McCabe et al, 1999;Naylor et al, 2003;van Mook et al, 2005). Tietke et al (2010) analyzed the outcomes of 358 patients treated with CAS using small closed-cell stents without distal protection. The peri-interventional and 30-day mortality/stroke rate was 4.19% (15/358).…”

On limitations of studies and limitations of therapy options for carotid stenosis: why play golf with only a sand wedge?

“…Many neuroradiologists feel that this is not a good option as their local experiences with CAS are much better than the results that have emerged from the trials. An example is reported in a single-centre experience within this issue [4]. However, is such data useless since operators tend to be favourable in assessing their outcome [5]?…”