Carotid artery stenting: a single-center experience

Yıl 2022, Cilt: 5 Sayı: 1, 138 - 143, 17.01.2022

Ali Burak Binboğa Gökalp Güzel Mehmet Onay Çetin Murat Altay

https://doi.org/10.32322/jhsm.1016133

Öz

Aim: This study aimed to present the results of carotid artery stenting (CAS) in the treatment of patients with symptomatic and asymptomatic carotid artery stenosis (Cs).
Material and Method: Between September 2016 and June 2021, patients who underwent CAS in the interventional radiology department were reviewed, retrospectively. The demographic data of patients, comorbidities, carotid stenosis rates, and early and late complication rates after treatment were recorded from medical records. Acute stent thrombosis, stroke, and death in the first 30 days after CAS were considered early periprocedural complications. Doppler ultrasonography (USG) examinations were scanned at 6 months after the procedure and restenosis rates were investigated.
Results: There were a total of 113 patients; 31.2% female and 68.8% male. Symptomatic Cs was present in 62.8% (n=71) and asymptomatic Cs in 37.2% (n=42) of the patients. The technical success rate was determined as 98.2%. Micro-thromboembolism (n=4), pseudoaneurysm at the femoral insertion site (n=2), and acute stent thrombosis (n=1) were observed as early complications. Restenosis was detected 6 months after stenting in 1 patient (1.4%) with symptomatic Cs on Doppler USG. The mortality rate was 0.8% (n=1).
Conclusion: CAS is an effective and safe treatment method in symptomatic and asymptomatic patients with Cs.

Anahtar Kelimeler

Carotid artery stenosis, carotid artery stenting, endovascular treatment, complication.

Destekleyen Kurum

NONE

Proje Numarası

NONE

Teşekkür

NONE

Kaynakça

• Saxena A, Ng EYK, Lim ST. Imaging modalities to diagnose carotid artery stenosis: progress and prospect. Biomed Eng 2019; 18: 1-23.
• Krist AH, Davidson KW, Mangione CM, et al. Screening for asymptomatic carotid artery stenosis: US preventive services Task force recommendation statement. JAMA 2021; 325: 476-81.
• Türk Börü Ü, Kulualp AŞ, Tarhan ÖF, et al. Stroke prevalence among the Turkish population in a rural area of İstanbul: A community-based study. SAGE Open Med 2018; 6: 1–6.
• Soto Á, Guillén‐Grima F, Morales G, Muñoz S, Aguinaga‐Ontoso I. Trends in mortality from stroke in the European Union. Eur J Neurol 2021; 28: 182-91.
• Ertaş F, Çevik MU, Aluçlu MU, et al. Karotis arter stentlemesi: İnvaziv bir üçüncü basamak merkez deneyiminin retrospektif değerlendirilmesi. Dicle Med J 2016; 43: 141-5.
• Onal Y, Velioglu M, Demir U, Celikoglu E, Karakas HM. Feasibility of distal mechanical thrombectomy in m3, a3, and p3 segments via a 0.013-inch delivery system: preliminary experience. Turk Neurosurg 2020; 30: 614-20.
• Brott TG, Hobson RW, Howard G, et al. Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med 2010; 363: 11-23.
• Silver FL, Mackey A, Clark WM, et al. Safety of stenting and endarterectomy by symptomatic status in the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST). Stroke 2011; 42: 675-80.
• Timaran CH, Mantese VA, Malas M, et al. Differential outcomes of carotid stenting and endarterectomy performed exclusively by vascular surgeons in the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST). J Vasc Surg 2013; 57: 303-8.
• Saba L, Mallarini G. A comparison between NASCET and ECST methods in the study of carotids: evaluation using Multi-Detector-Row CT angiography. Eur J Radiol 2010; 76: 42-7.
• Brott TG, Halperin JL, Abbara S, et al. 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease: Executive Summary. Circulation 2011; 124: 489-532.
• Wabnitz AM, Turan TN. Symptomatic carotid artery stenosis: surgery, stenting, or medical therapy? Curr Treat Options Cardiovasc Med 2017; 19: 1-12.
• The SPACE Collaborative Group. 30 day results from the SPACE trial of stent-protected angioplasty versus carotid endarterectomy in symptomatic patients: a randomised non-inferiority trial. Lancet 2006; 368: 1239-47.
• Sardar P, Chatterjee S, Aronow HD, et al. Carotid artery stenting versus endarterectomy for stroke prevention: a meta-analysis of clinical trials. JACC 2017; 69: 2266-75.
• Müller MD, Lyrer P, Brown MM, Bonati LH. Carotid artery stenting versus endarterectomy for treatment of carotid artery stenosis. Cochrane Database Syst Rev 2020.
• Stabile E, Giugliano G, Cremonesi A, et al. Impact on outcome of different types of carotid stent: results from the European Registry of Carotid Artery Stenting. EIJ 2016; 12: 265-70.
• Brinjikji W, Huston J, Rabinstein AA, Kim G-M, Lerman A, Lanzino G. Contemporary carotid imaging: from degree of stenosis to plaque vulnerability. J Neurosurg 2016; 124: 27-42.
• Choi J-H, Park H-S, Kim D-H, Cha J-K, Huh J-T, Kang M. Direct relationship between angiographic characteristics of carotid atherosclerotic plaque and filling defect in the cerebral protection filters: based on the conventional angiography. J Korean Neurosurg Soc 2013; 54: 93.
• Vatan MB, Acar AB, Aksoy M, et al. Predictors of periprocedural complications of carotid artery stenting - a multivariate analysis of a single-centre experience. Vasa 2016; 45: 387-93.
• Roubin GS, New G, Iyer SS, et al. Immediate and late clinical outcomes of carotid artery stenting in patients with symptomatic and asymptomatic carotid artery stenosis: a 5-year prospective analysis. Circulation 2001; 103: 532-7.
• Moulakakis KG, Mylonas SN, Lazaris A, et al. Acute carotid stent thrombosis: a comprehensive review. Vasc Endovascular Surg 2016; 50: 511-21.
• Texakalidis P, Giannopoulos S, Jonnalagadda AK, et al. Carotid artery endarterectomy versus carotid artery stenting for restenosis after carotid artery endarterectomy: a systematic review and meta-analysis. World Neurosurg 2018; 115: 421-9.
• Stilo F, Montelione N, Calandrelli R, et al. The management of carotid restenosis: a comprehensive review. Ann Transl Med 2020; 8: 1272.
• Eckstein HH, Ringleb P, Allenberg JR, et al. Results of the Stent-Protected Angioplasty versus Carotid Endarterectomy (SPACE).study to treat symptomatic stenoses at 2 years: a multinational, prospective, randomised trial. Lancet Neurol 2008; 7: 893-902.