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Carotid Arterial Stent Placement: Results and Follow-up in 53 Patients¹

¹ From the Interventional Neuroradiology Unit, Departments of Diagnostic and Interventional Radiology (E.C.K., M.S.K., G.P.v.S., W.M.), Vascular Surgery (M.M.L.B.), and Neurology (E.G.S.W.), Royal Perth Hospital, Perth, Australia. Received July 20, 2000; revision requested September 13; final revision received February 5, 2001; accepted March 9. Address correspondence to E.C.K., Department of Radiology, University Hospital, Petersgraben 4, 4031 Basel, Switzerland (e-mail: ekirsch@uhbs.ch).

PURPOSE: To describe the results, complications, and follow-up data after stent placement for occlusive internal carotid arterial disease and to compare the results with those in the literature.

MATERIALS AND METHODS: Carotid arterial stent placement was attempted in 57 arteries in 53 patients. Thirty-six (68%) of 53 patients were symptomatic. Forty-two (79%) of 53 patients had one to three clinically important comorbidities and were considered at high risk. All patients underwent pre- and postprocedural independent neurologic examinations. Follow-up consisted of serial duplex ultrasonography and clinical assessment.

RESULTS: The immediate technical success rate of stent deployment was 97%. Periprocedurally, three (three [5%] of 57 interventions) transient ischemic attacks and three (three [5%] of 57 interventions) minor strokes occurred. Two deaths occurred in the first 30 days (one myocardial infarction, one renal failure). One ipsilateral major stroke occurred 3 weeks after the procedure. The 30-day ipsilateral major stroke and death rate was 5% (three of 57 interventions). At 30 days, one of three patients with minor stroke had mild residual dysphasia. Treatment remained clinically successful in 48 (96%) of 50 patients. The restenosis rate was 4% (two patients).

CONCLUSION: Carotid arterial stent placement in a high-risk population has morbidity and mortality rates comparable to those of carotid endarterectomy in a lower risk population. Carotid arterial stent placement can be performed with a low restenosis rate.

Index terms: Carotid arteries, interventional procedures, 172.1269 • Carotid arteries, stenosis or obstruction, 172.721 • Carotid arteries, transluminal angioplasty, 172.1269

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