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. © 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 [10.1007/s11547-008-0326-x].

Carotid artery stenting: Findings based on 8 years' experience [Carotid Artery Stenting: risultati dopo otto anni di esperienza]

SIMONETTI, GIOVANNI MARIA EGISTO;GANDINI, ROBERTO;VERSACI, FRANCESCO;PAMPANA, ENRICO;
2009-01-01

Abstract

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. © 2008 Springer-Verlag Italia.
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/36 - Diagnostica per Immagini e Radioterapia
English
Con Impact Factor ISI
Angioplasty; Carotid stenosis; Follow-up; Restenosis; Stent
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 [10.1007/s11547-008-0326-x].
Simonetti, Gme; Gandini, R; Versaci, F; Pampana, E; Fabiano, S; Stefanini, M; Spinelli, A; Reale, C; Di Primio, M; Gaspari, E
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/39221
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