What is the clinical evidence from this study?

Study design: Observational. Population: Carotid artery stenosis (n=40). Intervention: Carotid artery stenting. Primary outcome: Early events (stroke, myocardial infarction, or death) during hospital stay and 30-day follow-up.

March 9, 2021Romanian Neurosurgery0 citationsOpen Access

Retrospective study on early outcomes of carotid stenting

SSSaurabh SharmaSUNY Upstate Medical University PSPrashant SinghAll India Institute of Medical Sciences Raipur RGRam Kumar GoyalGovernment Ayurvedic College and Hospital

Key Result

Carotid artery stenting was associated with a 0% rate of stroke, myocardial infarction, or death during the hospital stay and a 2.5% rate of minor stroke at 30-day follow-up.

Study Design

Type

Observational (n=40)

Multicenter

Structured PICO

Population

40 patients (mean age 71.6 years, 10% female) with symptomatic >50% or asymptomatic >70% carotid artery stenosis who underwent carotid artery stenting, followed for 30 days.

Intervention

Carotid artery stenting (CAS) using self-expandable hybrid stents and embolic protection devices (distal in 25% cases, proximal in 75% cases), with pre- or post-stent dilatation if required.

Outcome

Early events after Carotid artery stenting (CAS) including stroke, myocardial infarction, death, transient ischemic attack (TIA), and re-stenosis during hospital stay and at 1-month follow-up.hard clinical

Carotid artery stenting with embolic protection devices demonstrated high early procedural safety with no mortality or myocardial infarction and a very low stroke rate at 30 days.

Limitations

Retrospective design
Small sample size of 40 patients
Short follow-up period of 30 days
Single-center study
Durability of the procedure must be determined with a longer follow-up

Abstract

Objective: This study is conducted to evaluate the early events after Carotid artery stenting (CAS) among our patients in a single institute. Methods: This study was conducted on 40 patients. These patients underwent stenting of extracranial carotid arteries. Stenting was performed on symptomatic patients with carotid artery stenosis of more than 50 per cent of asymptomatic patients with more than 70 per cent carotid artery stenosis on Doppler ultrasonography. Follow up period for this study was of one month. Results: 40 patients who underwent CAS between August 2018 and June 2019 were included in the study. Self-expandable hybrid stents were implanted in all patients and pre or poststent-dilatation was performed if required after implantation. None of the patients suffered from a stroke, myocardial infarction or death due to CAS during their hospital stay. Only one patient had a minor stroke during follow up, which was managed conservatively. No transient ischemic attack (TIA), myocardial infarction or death during the follow-up period. Re-stenosis was not observed in the follow-up carotid Doppler ultrasonography; flow rates were within normal limits. Conclusions: Carotid stenting is a safe alternative to CEA (carotid endarterectomy) in the treatment of carotid stenosis regardless of age. CAS with cerebral protection can be performed safely in patients who are at high surgical risk, with low perioperative morbidity and mortality. The durability of the procedure must be determined with a longer follow-up. Further high-quality RCTs are required to address other shortcomings and controversies.

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