Carotid angioplasty stenting revisited: clinical and radiological (MRI) outcome

Cerebrovasc Dis. 2008;25(1-2):21-5. doi: 10.1159/000111495. Epub 2007 Nov 22.

Abstract

Background: Although carotid angioplasty and stenting (CAS) is widely used to treat carotid stenosis, recent studies point to the inferiority of the procedure compared with carotid endarterectomy.

Methods: We present 50 consecutive cases of CAS treated in our unit. Endarterectomy was contraindicated in these patients due to high operative risk. All the patients underwent a diffusion-weighted MRI (DWI) before and after the procedure and had a neurological assessment in a stroke unit.

Results: No deaths were recorded until 30 days after the procedure. Six patients [12%, confidence interval at 95% (CI(95)) = 3.7-20.2] had a positive DWI MRI after the procedure but only 2 (4%, CI(95) = 0-9.43) had a worse neurological status.

Conclusion: This study shows that CAS is feasible with a low morbid-mortality rate in patients with a high surgical risk. DWI is highly sensitive to detect neurological complications after the procedure.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angioplasty*
  • Carotid Stenosis / diagnosis
  • Carotid Stenosis / etiology
  • Carotid Stenosis / therapy*
  • Cohort Studies
  • Contraindications
  • Diffusion Magnetic Resonance Imaging
  • Endarterectomy, Carotid
  • Female
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Stents*
  • Treatment Outcome