Key result
Carotid artery stenting for high-grade stenosis carries a ~7% 30-day complication rate.
Why the study?
The safety and complication rates of carotid artery stenting in patients with high grade carotid stenosis were evaluated in a prospective case study.
Observational (n=190)
No
Carotid artery stenting with a self-expanding nitinol stent and emboli capture system showed a 30-day complication rate of 6.8%, which the authors note is comparable to historical endarterectomy rates.
CAS with 24h monitoring yielded 6.8% 30-day complications; leaves open whether single-center results generalize beyond selected cohorts.
Carotid artery stenting was carried out in a prospective consecutive case study. All interventions were done by the same investigator (PH), and one type of stenting device was used. Additionally, periprocedural monitoring was carried out for at least 24 h. 190 patients were included (70±8.9 years). All had a high grade stenosis (>70% according to North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria). 140 were men and 50 were women. 104 (55%) had symptomatic stenosis and 86 (45%) had asymptomatic stenosis. A self-expanding nitinol-carotis stent was used (Cordis Precise stent; Johnson and Johnson) with an emboli capture guidewire basket system (Angioguard; Cordis). 30 day complications (infarct, hemorrhage, death due to either) were seen in 13 cases (6.8%). Disabling complications with an increase in the modified Rankin Scale by >2 points after 6 months were seen in five cases (2.6%). The rate of complications after carotid artery stenting was comparable with that after carotid endarterectomy (from the literature). No correlation was seen between complications and age, gender, diabetes, hypertension, symptomatic stenosis or plaque morphology. This may be because of the the 24 h post-procedural monitoring.
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Claus et al. (2009) conducted an observational in Carotid artery stenosis (n=190). Carotid artery stenting was evaluated on 30 day complications (infarct, hemorrhage, death due to either). Carotid artery stenting for high-grade stenosis resulted in a 30-day complication rate of 6.8% and a 6-month disabling complication rate of 2.6%.
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