This Article Full Text (PDF) All Versions of this Article: 1538574408327571v1 43/2/144    most recent References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal 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 Albacker, T. B. Articles by Abraham, C. Z. Search for Related Content PubMed PubMed Citation Articles by Albacker, T. B. Articles by Abraham, C. Z. Social Bookmarking                         What's this?

Carotid Artery Angioplasty and Stenting: Introduction of a New Technique Into an Established Vascular Surgery Center

Division of Vascular Surgery, Department of Surgery, McGill University, Montreal, Canada, dr_turki{at}yahoo.com

Thamer A. Nouh, MD

Division of Vascular Surgery, Department of Surgery, McGill University, Montreal, Canada

Saleh I. Alabbad, MD

Division of Vascular Surgery, Department of Surgery, McGill University, Montreal, Canada

Marc M. Corriveau, MD

Division of Vascular Surgery, Department of Surgery, McGill University, Montreal, Canada

Kent S. MacKenzie, MD

Division of Vascular Surgery, Department of Surgery, McGill University, Montreal, Canada

Daniel I. Obrand, MD

Division of Vascular Surgery, Department of Surgery, McGill University, Montreal, Canada

Oren K. Steinmetz, MD

Division of Vascular Surgery, Department of Surgery, McGill University, Montreal, Canada

Cherrie Z. Abraham, MD

Division of Vascular Surgery, Department of Surgery, McGill University, Montreal, Canada

Background: The aim of this study was to review our initial experience with the introduction of carotid artery angioplasty and stenting as a treatment for carotid stenosis in high-risk patients and compare clinical outcomes to carotid endarterectomy patients treated over the same time period at our center. Methods: A total of 265 carotid revascularization procedures (45 carotid artery angioplasty and stenting and 220 carotid endarterectomy) were performed over 3 years period. In the carotid artery angioplasty and stenting group, 93% were at high risk according to the current reporting standards. Death, neurological events, and restenosis rates were compared at 30 days and at most recent follow-up. Results: Mean follow-up for all patients was 18 months (range 0-48 months). Carotid artery angioplasty and stenting group had higher cardiac risk than carotid endarterectomy group (13% vs 2%, P < .05). High-risk carotid lesions were present in 67% of carotid artery angioplasty and stenting patients. There was a tendency toward higher restenosis rate in carotid artery angioplasty and stenting than in carotid endarterectomy patients (35% vs 15%, P = .06). Combined stroke and death was higher in the carotid stenting group (4% and 9%) compared to the carotid endarterectomy group (0.5% and 0.5%) at 30 days and at late follow-up, respectively (P = .04 and .00). Conclusion: Restenosis and stroke were observed more frequently in our initial experience in patients undergoing carotid artery angioplasty and stenting compared with carotid endarterectomy patients during the same time period. These differences disappeared in high-risk patients. Further studies, to evaluate the effect of the learning curve on early results as well as follow-up for intermediate and long-term durability of carotid artery angioplasty and stenting in high-risk patients, are required.

Key Words: carotid artery stenting • carotid endarterectomy • restenosis • stroke • high risk

This version was published on April 1, 2009

Vascular and Endovascular Surgery, Vol. 43, No. 2, 144-149 (2009)
DOI: 10.1177/1538574408327571


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