Purpose: Carotid artery stenting (CAS) may be an alternative to surgical endarterectomy not only in high-risk patients. Few data are available regarding the long-term clinical efficacy of CAS with the use of cerebral protection devices and the incidence of restenosis. Our experience demonstrates that if certain requirements are fulfilled, CAS can be considered a safe and effective treatment with high short-and long-term success rates. Materials and methods: In the past 8 years, we treated 1,003 patients (1,096 arteries) affected by internal carotid artery stenosis, 93 with bilateral stenosis. Of these, 567 (51.74%) were symptomatic and 529 (48.26%) asymptomatic lesions. The preprocedural evaluation was performed with Doppler ultrasound (US), magnetic resonance (MR) angiography/computed tomography (CT) angiography and a neurological evaluation. Antiplatelet therapy was administered before and after the procedure. Results: Technical success was achieved in 1,092 cases (99.6%), and a cerebral protection device was successfully used in 1,019 procedures (92.9%). The 30-day transient ischaemic attack (TIA)/stroke/death rate was 2.16%: death (0.18%) major stroke (0.45%) and minor stroke/TIA (1.53%). During a follow-up up to 8 years, restenoses occurred in 39 cases (3.57%), of which 28 were post-CAS (2.57%) and 11 post-CAS performed for restenosis after carotid endarterectomy (1%). Only five symptomatic restenoses >80% were treated with a repeated endovascular procedure. Conclusions: A retrospective analysis of our experience suggests that CAS is a safe and effective procedure with better results than endarterectomy. In up to 8 years of follow-up, CAS seems to be effective in preventing stroke, with a low restenosis rate. Â© 2008 Springer-Verlag Italia.
Simonetti, G., Gandini, R., Versaci, F., Pampana, E., Fabiano, S., Stefanini, M., et al. (2009). Carotid artery stenting: Findings based on 8 years' experience [Carotid Artery Stenting: risultati dopo otto anni di esperienza]. LA RADIOLOGIA MEDICA, 114(1), 95-110.
|Tipologia:||Articolo su rivista|
|Citazione:||Simonetti, G., Gandini, R., Versaci, F., Pampana, E., Fabiano, S., Stefanini, M., et al. (2009). Carotid artery stenting: Findings based on 8 years' experience [Carotid Artery Stenting: risultati dopo otto anni di esperienza]. LA RADIOLOGIA MEDICA, 114(1), 95-110.|
|IF:||Con Impact Factor ISI|
|Settore Scientifico Disciplinare:||Settore MED/36 - Diagnostica per Immagini e Radioterapia|
|Revisione (peer review):||Sì, ma tipo non specificato|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1007/s11547-008-0326-x|
|Stato di pubblicazione:||Pubblicato|
|Data di pubblicazione:||2009|
|Titolo:||Carotid artery stenting: Findings based on 8 years' experience [Carotid Artery Stenting: risultati dopo otto anni di esperienza]|
|Autori:||Simonetti,G; Gandini,R; Versaci,F; Pampana,E; Fabiano,S; Stefanini,M; Spinelli,A; Reale,CA; Di Primio,M; Gaspari,E|
|Appare nelle tipologie:||01 - Articolo su rivista|