Global experience in cervical carotid artery stent placement

Abstract

The purpose of this article is to review and update the current status of carotid artery stent placement in the world. Surveys to major interventional centers in Europe, North and South America, and Asia were initially completed in June 1997. Subsequent information from these 24 centers in addition to 12 new centers has been obtained to update the information. The survey asked the various questions regarding the patients enrolled, procedure techniques, and results of carotid stenting, including complications and restenosis. The total number of endovascular carotid stent procedures that have been performed worldwide to date included 5,210 procedures involving 4,757 patients. There was a technical success of 98.4% with 5,129 carotid arteries treated. Complications that occurred during the carotid stent placement or within a 30‐day period following placement were recorded. Overall, there were 134 transient ischemic attacks (TIAs) for a rate of 2.82%. Based on the total patient population, there were 129 minor strokes with a rate of occurrence of 2.72%. The total number of major strokes was 71 for a rate of 1.49%. There were 41 deaths within a 30‐day postprocedure period resulting in a mortality rate of 0.86%. The combined minor and major strokes and procedure‐related death rate was 5.07%. Restenosis rates of carotid stenting have been 1.99% and 3.46% at 6 and 12 months, respectively. The rate of neurologic events after stent placement has been 1.42% at 6–12‐month follow‐up. Endovascular stent treatment of carotid artery atherosclerotic disease is growing as an alternative for vascular surgery, especially for patients that are high risk for standard carotid endarterectomy. The periprocedure risks for major and minor strokes and death are generally acceptable at this early stage of development and have not changed significantly since the first survey results. Cathet. Cardiovasc. Intervent. 50:160–167, 2000. ©2000 Wiley–Liss,Inc.

Neointimal proliferation within carotid stents is more pronounced in diabetic patients with initial poor glycaemic state

“…The incidence of carotid stent restenoses was reported to be low in several single-center studies [4,5,6]. This was also confirmed in a global questionnaire survey [7], comprising data on more than 5200 carotid stents, where a restenosis rate of 3.46% at 12 months was reported. In contrast, the incidence of carotid stent restenoses in the CAVATAS [8] is surprisingly high (22%) at the 12-month follow-up.…”

Stent-PTA der Karotis: Behandlungstechnik und medikament�se Begleitbehandlung

“…In einer Vielzahl von veröffent-lichten Fallkontrollserien [10, 22-24, 37, 50, 57, 67, 78, 86], monozentrischen Vergleichsstudien [7,39,42] und klinischen Registern [9,[81][82][83] [30,72]. Diese Art der Therapie führte allerdings zu einem unakzeptablen Anstieg embolischer Schlaganfallkomplikationen [45].…”

Clinical results of carotid artery stenting with a nitinol self-expanding stent (SMART stent)

“…In past years, carotid artery stenting (CAS) has developed as an alternative to carotid surgery for treating high-grade stenosis of the carotid artery [1,2,3,4,5,6]. …”