Endovascular Stents for Carotid Artery Occlusive Disease

Wholey, Michael H.; Wholey, Mark H.; Jarmolowski, Chester R.; Eles, Gustav; Levy, Doron; Buecthel, Jack

doi:10.1583/1074-6218(1997)004<0326:esfcao>2.0.co;2

Cited by 153 publications

(31 citation statements)

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“…Unsere Erfahrungen bei 65 Patienten mit dem Karotisstent sind in Übereinstimmung mit den Ergebnissen bisher publizierter Daten (1,11,13,15,21,24). Die weltweit größte Erfahrung mit der Karotisintervention besitzt Mathias aus Dortmund, der bisher über 600 Patienten derart behandelt hat (13,14).…”

Section: Diskussionunclassified

“…Obwohl nur 2 Patienten (3 %) (1 Todesfall, 1 Major-Stroke) einen schweren Nachteil erlitten haben, bleibt doch das thromboembolische Risiko das größte Problem der Intervention. In Publikationen, in denen das Auftreten von TIAs registriert wurde, waren diese in etwa 4-5 % der Fälle zu beobachten (1,21). In chirurgischen Serien werden TIAs nicht erwähnt, da nur neurologische Störungen, die länger als 24 h andauern, registriert wurden (16).…”

Section: Diskussionunclassified

“…Ein erhöhtes Risiko für zerebrale Ereignisse haben ältere Patienten mit langstreckigen und multiplen Stenosen, solche mit ulzerierten Plaques mit thrombotischen Auflagerungen und starken zirkulären Verkalkungen (15,21). Aus morphologischen Gründen haben wir zwei jüngere Patienten zur Intervention abgelehnt.…”

Section: Diskussionunclassified

“…Ballondehnungen von Carotis-interna-Stenosen wurden ebenfalls vereinzelt in den frühen 80er Jahren durchgeführt (13). Erst die zusätzliche Implantation eines Stents in die Karotis brachte derartig gute Ergebnisse, daß der Karotisstent seit 4-5 Jahren weltweit bereits an mehreren tausend Patienten erfolgreich -mit niedrigen Komplikationsraten -angewendet werden konnte (1,2,9,(11)(12)(13)(14)(19)(20)(21)(22)(23)(24).…”

Section: Introductionunclassified

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Karotisstent: Akutergebnisse und Komplikationen

et al. 1999

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The treatment of carotid stenoses with balloon angioplasty and stenting is a new and not generally established method. During a one year period 65 patients (22 female, 43 male, mean age: 73 years, 47 with neurologic symptoms, 8 with contralateral carotid occlusion) with significant (>70%) carotid stenosis were treated with balloon angioplasty and balloon expandable stents. The primary technical success rate was 98% (65/66 patients) respectively 99% (69/70 stenoses). A combined procedure was performed in 11 /17%) patients with stenting in both carotid arteries in 4 patients with additional coronary interventions in 6 patients and stenting of the origin of the common carotid artery in one patient.Severe neurologic complications occurred in 4 (6.2%) patients (1 death, 1 major stroke, 2 minor strokes) and short lasting neurologic deficits in additional 4 (6.2%) patients. Cardiovascular complications were not observed. Local (inguinal) problems occurred in 3 (4.5%) patients (2 aneurysma spuria, 1 transfusion for hematoma). Frequently, balloon insufflation was associated with bradycardia (40%) and additional hypotension (11%). In summary, carotid stenting can be performed with technically high success rates (99%), but it is adversely influenced by not infrequent thromboembolic cerebral events (12.4%). The possibility to perform combined procedures with interventions in other vessels (both carotid arteries, coronary arteries, aortic arch arteries) is advantageous.

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Section: Diskussionunclassified

Section: Introductionunclassified

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Karotisstent: Akutergebnisse und Komplikationen

et al. 1999

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“…Endovascular stents are evolving as the method of managing carotid artery occlusive disease in a selected subset of patients. Currently there are trials in process for randomizing endovascular stenting vs. carotid endarterectomy for proximal internal carotid artery stenosis [1,2].…”

Section: Introductionmentioning

confidence: 99%

Use of coronary artery stents in the treatment of internal carotid artery stenosis at the base of the skull

Mencken¹,

Wholey²,

Eles³

1998

Cathet. Cardiovasc. Diagn.

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Secondary Stroke Prevention in the Era of Carotid Stenting

2010

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Stroke is a leading cause of morbidity and mortality worldwide. Traditional therapy for extracranial carotid artery occlusive disease, a significant risk factor for stroke, consists of optimal medical management and selective surgical treatment with carotid endarterectomy (CEA) for stroke risk reduction. Buoyed by the widespread application of percutaneous interventions for the treatment of coronary artery disease, carotid artery stenting (CAS) has steadily developed during the past decade as an alternative to CEA for patients who might benefit from surgical treatment. With greater operator experience have come advances in CAS techniques and patient selection criteria, and several single-center studies and industry-sponsored stent registries have demonstrated excellent results for CAS, especially compared with the landmark randomized CEA trials of the 1980s. Nevertheless, CAS has emerged as one of the most controversial procedures in the era of modern medicine, and recently published randomized trials from Europe have only stoked the fires of controversy. This study reviews the best available data for CAS as an alternative therapy to CEA for stroke risk reduction and gives an overview of eagerly anticipated large randomized trials.

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Endovascular Stents for Carotid Artery Occlusive Disease

Abstract: The use of stents in the treatment of cervical carotid occlusive disease appears feasible, effective in the short term, and without excessive risk of periprocedural stroke.

Cited by 153 publications

References 23 publications

Karotisstent: Akutergebnisse und Komplikationen

Karotisstent: Akutergebnisse und Komplikationen

Use of coronary artery stents in the treatment of internal carotid artery stenosis at the base of the skull

Secondary Stroke Prevention in the Era of Carotid Stenting

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