geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Eight-year institutional review of carotid artery stenting


, : Eight-year institutional review of carotid artery stenting. Journal of Vascular Surgery 51(5): 1145-1151

Vascular surgeons have increasingly become proficient in carotid artery stenting (CAS) as an alternative treatment modality for cervical carotid artery occlusive disease. We analyzed our early and late outcomes of CAS over the last 8 years. We report a single-center retrospective review of 388 carotid bifurcation lesions treated with CAS using cerebral embolic protection from May 2001 to July 2009. Data analysis includes demographics, procedural records, duplex exams, arteriograms, and two-view plain radiographs over a mean follow-up time of 23.0 months (interquartile range, 10.9-35.4). At the time of treatment, the mean age of the entire cohort (76% men and 24% women) is 71 years; 13% were >/=80 years of age, and 31% had a prior history of either carotid endarterectomy (CEA) and/or external beam neck irradiation (XRT). The mean carotid stenosis is 80%, and asymptomatic lesions represent 69% of the group. Overall 30-day rates of death, stroke, and myocardial infarction are 0.5%, 1.8%, and 0.8%, respectively. The combined death/stroke rate at 30 days is 2.3%. The 30-day major/minor stroke rates for analyzed subgroups are statistically significant only for XRT/recurrent stenosis vs de novo lesions, 0% and 2.6% (P = .03), but not for asymptomatic vs symptomatic patients, 1.9% and 1.7% (P = .91) and age <80 vs >/=80, 2.0% and 1.8% (P = .52), respectively. At long-term, the freedom from all strokes at 12, 24, 36, and 48 months was 99.2%, 97.6%, 96.7%, and 96.7%, respectively. At late follow-up, the restenosis rate is 3.5%. Restenosis rates for recurrent stenosis/XRT vs de novo lesions are 2.7% and 3.4% (P = .39). Among the restenotic lesions were two associated type III stent fractures in de novo lesions, both of which were closed-cell stents. An additional two other type I fractures have been identified, yielding a stent fracture rate of 5.5%. The late death rate for the entire group is 16.8%, with one stent-related death secondary to ipsilateral stroke at 20 months (0.3% death rate). Vascular surgeons performing CAS with embolic protection can achieve good early and late outcomes that are comparable to CEA benchmarks. Late stent failures (stroke, restenosis, and/or stent fatigue), while uncommon, are a recognized delayed problem.

US$19.90

PMID: 20304594

DOI: 10.1016/j.jvs.2009.12.025


Other references

Langhof, H., 1956: Hyperergic pan-vasculitis as multiple gangrene of the skin. Archiv für Klinische und Experimentelle Dermatologie 202(4): 331-339

Bailey, A.; Hallam, K.; Hurst, K., 1987: Nursing practice. Triage on trial. Nursing Times 83(44): 65-66

Sone, Y.; Kudo, Y.; Oba, R.; Otsuka, Y., 2010: Effects of oxygen concentration on the expression of an antioxidant gene in HepG2. To clarify the effects of O(2) concentration (cO(2)) on antioxidant gene expression in human hepatocytes, mRNA expression of HepG2 cells cultured at 1, 3, and 5% cO(2) and atmospheric gas-phase, was measured. The expression of some genes fluctuate...

Hutton, D.J., 1997: The clinical nurse specialist in tissue viability services. Journal of Wound Care 6(2): 88-90

Polakowski, L.; Senger, A.; Strzyzewski, H., 1953: Trophic changes in the hip joint consecutive to conservative treatment of congenital dislocation. Chirurgia Narzadow Ruchu i Ortopedia Polska 18(2): 143-148

Mateos-Hernández, L.; Villar, M.; Moral, A.; Rodríguez, C.García.; Arias, T.Alfaya.; de la Osa, Vónica.; Brito, F.Feo.; Fernández de Mera, I.G.; Alberdi, P.; Ruiz-Fons, F.; Cabezas-Cruz, A.; Estrada-Peña, Aín.; de la Fuente, Jé., 2017: Tick-host conflict: immunoglobulin E antibodies to tick proteins in patients with anaphylaxis to tick bite. Tick-borne infectious diseases and allergies are a growing problem worldwide. Tick bite allergy has been associated with the direct effect of immunoglobulin E (IgE) response to tick salivary antigens, or secondary to the induction of allergy to re...

Heidari, S.Morteza.; Loghmani, P., 2014: Assessment of the effects of ketamine-fentanyl combination versus propofol-remifentanil combination for sedation during endoscopic retrograde cholangiopancreatography. Endoscopic retrograde cholangiopancreatography (ERCP) as a diagnostic and treatment procedure is used in most biliary tract and pancreatic. Either sedation or general anesthesia could be considered for this procedure. Combining a sedative with an...

Barnett D.; Howden M.E.H., 1986: Partial characterization of an allergenic glycoprotein from peanut arachis hypogaea. A concanavalin A-reactive glycoprotein allergen has been isolated from peanut (Arachis hypogaea). The allergen was separated by affinity chromatography and purified by gel permeation and ion-exchange chromatography. The monomeric molecular weight...

Fournet Fayard J.; Maisonnier M.; Kohler R.; Bonnin M.; Michel C.R., 1987: Clinical and therapeutic aspects of brachymetapody report of three cases. Pediatrie 42(4): 267-272

Pfäffli, P.; Säämänen, A., 1993: The occupational scene of styrene. Styrene readily undergoes homopolymerization as well as copolymerization with other monomers, such as acrylonitrile and butadiene. In closed polymerization processes, exposure of workers to styrene is generally lower than current reference values...