Carotid Artery Stenting

2019 ◽  
Author(s):  
Craig Weinkauf ◽  
Wei Zhou
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Artery Stenting ◽  
New Technology ◽  
Current Data ◽  
Carotid Revascularization ◽  
Long Term Follow Up ◽  
Stroke Death

In addition to medical therapy and carotid endarterectomy (CEA), carotid artery stenting (CAS) is a treatment option for carotid stenosis. Multi-centered clinical trials showed that CAS has a similar composite outcome of stroke, death, and MI to CEA.  However,  CAS has a higher stroke complication than CEA.  Although controversy remains regarding appropriate patient selection for CAS, consensus is that CAS is a good option in patients who need an intervention and are at high risk for endarterectomy. New technology, techniques, and treatments continue to develop with resultant controversy and slow changes in practice.  Although long-term follow-up is still needed. current data showed Transcarotid Carotid Revascularization (TCAR) has similar perioperative stroke risk compared to CEA, suggesting TCAR is a promising technique for CAS. This review 11 figures, 3 tables, and 36 references. Key Words: carotid artery angiogram, carotid artery stenting, carotid endarterectomy, Carotid Revascularization Endarterectomy versus Stenting Trial, cerebrovascular disease, transcarotid artery revascularization

Carotid Artery Stenting

2019 ◽  
Author(s):  
Craig Weinkauf ◽  
Wei Zhou
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Artery Stenting ◽  
New Technology ◽  
Current Data ◽  
Carotid Revascularization ◽  
Long Term Follow Up ◽  
Stroke Death

In addition to medical therapy and carotid endarterectomy (CEA), carotid artery stenting (CAS) is a treatment option for carotid stenosis. Multi-centered clinical trials showed that CAS has a similar composite outcome of stroke, death, and MI to CEA.  However,  CAS has a higher stroke complication than CEA.  Although controversy remains regarding appropriate patient selection for CAS, consensus is that CAS is a good option in patients who need an intervention and are at high risk for endarterectomy. New technology, techniques, and treatments continue to develop with resultant controversy and slow changes in practice.  Although long-term follow-up is still needed. current data showed Transcarotid Carotid Revascularization (TCAR) has similar perioperative stroke risk compared to CEA, suggesting TCAR is a promising technique for CAS. This review 11 figures, 3 tables, and 36 references. Key Words: carotid artery angiogram, carotid artery stenting, carotid endarterectomy, Carotid Revascularization Endarterectomy versus Stenting Trial, cerebrovascular disease, transcarotid artery revascularization

scholarly journals CAROTID ARTERY STENTING IN OCTOGENARIANS: SUCCESS RATE, COMPLICATIONS AND LONG-TERM FOLLOW-UP OF A SINGLE-CENTER COHORT

2016 ◽  
Vol 67 (13) ◽  
pp. 299
Author(s):  
Juergen Kammler ◽  
Hermann Blessberger ◽  
Alexander Kypta ◽  
Michael Lichtenauer ◽  
Thomas Lambert ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Success Rate ◽  
Carotid Artery Stenting ◽  
Single Center ◽  
Long Term Follow Up

scholarly journals Carotid artery stenting: Results and long-term follow-up

2006 ◽  
Vol 54 (1) ◽  
pp. 68 ◽  
Author(s):  
AK Gupta ◽  
S Purkayastha ◽  
TR Kapilamoorthy ◽  
MD Nair ◽  
T Krishnamoorthy ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Long Term Follow Up

scholarly journals Carotid artery stenting has similar outcomes in men and women

2021 ◽  
Vol 20 ◽  
Author(s):  
Marina Ansuategui ◽  
Gabriela Ibarra ◽  
Carmen Romero ◽  
Alejandra Comanges ◽  
Jose A. Gonzalez-Fajardo
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Risk ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Therapeutic Option ◽  
Stent Patency ◽  
Cerebrovascular Events ◽  
Long Term Follow Up

Abstract Background The aim of carotid interventions is to prevent cerebrovascular events. Endovascular treatment (carotid-artery-stenting/CAS) has become established as an alternative to open surgery in some cases. Historically, female sex has been considered as a perioperative risk factor, however, there are few studies regarding this hypothesis when it comes to CAS. Objectives To analyze the CAS results in our center adjusted by sex. Methods A retrospective cohort study was designed, including patients with carotid atheromatosis operated at a single center from January 2016 to June 2019. Our objective was to compare cardiovascular risk, including myocardial infarction, stroke, and mortality, by sex. Follow-up rates of stent patency, restenosis, stroke, myocardial infarction, and death were reported. Results 71 interventions were performed in 50 men (70.42%) and 21 women (29.57%). Mean age was 70.50 ± 10.72 years for men and 73.62 ± 11.78 years for women. Cardiovascular risk factors did not differ significantly between sexes. Mean follow-up was 11.28 ± 11.28 months. There were no significant differences in neurological events during follow-up. No adverse cardiological events were detected at any time. Regarding the mortality rate, during medium-term follow up there were 2 neurological related deaths with no significant differences between sexes (p=0.8432). Neither sex had higher rated of restenosis during long term follow-up (5.63% vs. 1.41%, p = 0.9693) or reoperation (1.41% vs. 1.41%, p = 0.4971). All procedures remained patent (<50% restenosis). Conclusions Despite the limitations of our study, CAS is a therapeutic option that is as effective and safe in women as in men. No sex differences were observed.

Abstract WP133: Long-term Outcomes of Carotid Endarterectomy and Carotid Artery Stenting: Real-World Status of Single Institute in Japan

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Kohkichi Hosoda ◽  
Taichiro Imahori ◽  
Atsushi Fujita ◽  
Yusuke Yamamoto ◽  
Hidehito Kimura ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Real World ◽  
Carotid Artery Stenting ◽  
Long Term Outcomes ◽  
End Point ◽  
Bilateral Carotid ◽  
Free Rate ◽  
Stroke Death

Introduction: We investigated long-term outcomes of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in our hospital to assess the outcomes of real-world practice in single institute of Japan. Methods: Between August 2006 and July 2014, 236 consecutive carotid revascularizations with either CEA or CAS were performed in our institute. The initial treatment was regarded as the starting point in the cases of the patients who received treatment by bilateral carotid artery stenosis or retreatment. We assessed the long-term outcomes with survival analyses. Results: A total of 210 patients (CEA 128, CAS 82), including 94 symptomatic patients, were enrolled in the current study with mean follow-up period of 45.8 months. The periprocedural stroke/death/myocardial infarction (MI) rate was 3.1% for CEA and 4.9% for CAS groups (p=0.71). Estimates of the 4-year event-free rate from the primary end point (the composite of any stroke, death, or MI within 30 days and any ipsilateral stroke thereafter) using competing risk analysis were 3.1% for CEA and 8.6% for CAS (P=0.041). Kaplan-Meier estimates of the 4-year event-free rate from the secondary end point (the composite of any stroke, death, or MI within 30 days and any stroke or death thereafter) were 12.8% for CEA and 20.1% for CAS (P=0.051). Age (Hazard ratio [HR], 1.14/year [95%CI, 1.03-1.26]; p = 0.012) and CAS (HR, 3.5 [95%CI, 1.05-11.5]; p = 0.04 ) were significant predictors for the primary end point in multivariate analysis. For the secondary end point, age (HR, 2.1/10year [95%CI, 1.27-3.47]; p = 0.004) and CAS (HR, 2.0 [95%CI, 1.04-3.83], p = 0.037) were significant predictors. The inclusion of higher risk patients in the CAS group may have been the reason for CAS being a risk factor. Conclusion: The current study on real-world practices demonstrated perioperative and long-term outcomes that were comparable to previous major studies of large numbers of patients.

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