Angioplasty with Stenting in Treatment of Carotid Artery Stenosis: Report of a 3-year series

Carotid angioplasty with stent placement has been proposed as an alternative treatment for revascularization of carotid artery stenosis. In this article, we describe our series of stent-assisted carotid angioplasty and summarize the safety and feasibility of this procedure. We performed 38 cervical carotid bifurcation angioplasty with stents in 35 patients during November 1999 to December 2002. The carotid bifurcation stenosis was induced by atherosclerotic plaque in 33 cases and post-radiation stenosis in 2 cases. The inclusion criteria for stenting was diameter stenosis >70% in any patients or stenosis >50% in symptomatic patients. Diagnostic cerebral angiography was performed before every procedures. Percutaneous transluminal angioplasty and stenting were performed with the goal of final diameter stenosis <30%. Any event occurring during procedure and within 3 days after procedure was recorded as procedure-relative. New neurological deficits or death occurred during follow-up was documented as late event. The mean pre-treatment diameter stenosis was 74.0% and final residual diameter stenosis 9.1%. The rate of peri-procedural morbidity was 5.3%. No peri-procedural death was noted. One patient suffered from ipsilateral minor stroke and another suffered from acute myocardial infarction. Five late ipsilateral or bilateral ischemic strokes (14.3%) occurred in mean 15.9 months' follow-up. The restenosis rate was 11.4%. It is safe and feasible to treat carotid stenotic patient using stent-assisted angioplasty.