This Article Full Text (PDF) All Versions of this Article: 1538574408318477v1 42/5/433    most recent References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by AbuRahma, A. F. Articles by Flaherty, S. K. Search for Related Content PubMed PubMed Citation Articles by AbuRahma, A. F. Articles by Flaherty, S. K. Pubmed/NCBI databases Medline Plus Health Information Angioplasty Social Bookmarking                         What's this?

Safety and Efficacy of Carotid Angioplasty/Stenting in 100 Consecutive High Surgical Risk Patients: Immediate and Long-Term Follow-up

R. C. Byrd Health Sciences Center, West Virginia University, Charleston, West Virginia, ali.aburahma{at}camc.org

Mark C. Bates, MD

R. C. Byrd Health Sciences Center, West Virginia University, Charleston, West Virginia

Kris Eads, MD

R. C. Byrd Health Sciences Center, West Virginia University, Charleston, West Virginia

Lauren Armistead, MD

R. C. Byrd Health Sciences Center, West Virginia University, Charleston, West Virginia

Sarah K. Flaherty, BS

R. C. Byrd Health Sciences Center, West Virginia University, Charleston, West Virginia

Background/purpose. This study analyzes the safety and efficacy of carotid angioplasty/stenting (CAS) with embolic protection devices in high surgical risk (HSR) patients. Patient population/methods. This study includes 100 consecutive HSR patients, who were followed prospectively, and had carotid duplex ultrasounds at 1 month and every 6 months thereafter. A Kaplan—Meier lifetable analysis was used to estimate survival rates, rates of freedom from stroke, and freedom from 50% in-stent restenosis. Results. Mean age was 69.6 years. There were 59 men and 41 women. Mean follow-up was 26.1 months (range, 1-50). Indications for CAS were symptomatic 50% stenosis in 47% and 80% asymptomatic stenosis in 53%. Procedure success rate was 100%. HSR includes 33% with restenosis and cardiac comorbidity, 21% with restenosis and cardiac/medical comorbidities, 13% with restenosis only, and 33% with cardiac/medical comorbidities. The 30-day perioperative stroke rate was 2% with no perioperative deaths or MI. Stroke-free survival rates were 95%, 91%, 83%, 79%, and 73% at 1, 2, 3, and 4 years, respectively. There were no late strokes. Stroke-free rate was 98% at 1, 2, 3, and 4 years, respectively. Freedom from 50% in-stent restenosis was 98%, 93%, 90%, and 79% at 1, 2, 3, and 4 years, respectively. Six patients had asymptomatic 80% in-stent restenosis; 3 underwent reintervention (percutaneous transluminal angioplasty). The incidence of in-stent restenosis was not statistically significant between patients who had restenosis after carotid endarterectomy and patients with primary stenting (P = .21). Conclusions. CAS with embolic protection devices in HSR patients is safe and effective.

Key Words: carotid angioplasty/stenting • high surgical risk • safety • embolic protection device

This version was published on October 1, 2008

Vascular and Endovascular Surgery, Vol. 42, No. 5, 433-439 (2008)
DOI: 10.1177/1538574408318477


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?