Long-Term Results of Elective Stenting for Severe Carotid Artery Stenosis in Taiwan

Abstract

Stenting for severe carotid stenosis has been proposed as an alternative for patients with high surgical risk for endarterectomy, but its effectiveness and safety has never been evaluated in large case series in a pure Asian population. One hundred and eighteen ethnic Chinese patients (mean age 72.8 years) with 129 severely narrowed carotid arteries were stented electively using self-expanding stents. The mean pre-treatment diameter stenosis was 85% and final residual diameter stenosis 14%. The peri-procedural stroke and death rate was 4.2%. One (0.8%) late ischemic stroke and 2 (1.7%) deaths occurred during a mean follow-up of 16.3 months, and the restenosis rate was 3.1%. Carotid stenting, therefore, can be done safely and effectively in Chinese patients.

Feasibility of Endovascular Recanalization for Symptomatic Cervical Internal Carotid Artery Occlusion

“…One acute basilar occlusion with fatal posterior infarction was the only complication, but the etiology was most likely an unfortunate independent embolic episode, either artery-to-artery or cardiogenic. Thus, the periprocedural complication rate of the current series was not different from that of previous CAS studies (10,11,13), and certainly compared favorably with the CEA or EC-IC bypass surgery results in ICA occlusion (5,14).…”

Procedural Safety and Potential Vascular Complication of Endovascular Recanalization for Chronic Cervical Internal Carotid Artery Occlusion

“…The short-term outcomes and complications compared favorably with those of surgical treatment for chronic ICAO 3,4 and were similar to those of stenting and endarterectomy for ICA stenosis. 12,14,15 Instead of embolism, compromised cerebral perfusion may be the most important etiology of ipsilateral ischemic events in patients with chronic ICAO. In the Harvard Stroke Registry, 20% (95 of 471) of the stroke patients experienced deterioration after the initial event, and 33% had a large artery occlusion.…”

Prevalence of concomitant atherosclerotic arterial diseases in patients with significant cervical carotid artery stenosis in Taiwan

“…The surgical risk in patients with coexisting coronary and carotid stenosis is significantly increased, whether a staged approach or simultaneous combined coronary bypass grafting and carotid endarterectomy is chosen [29][30][31][32]. Considering the high concurrent rate of multi-vessel or left main CAD in our series, endovascular treatment for the carotid stenosis might be a safe and effective option [18][19][20][21][33][34][35].…”