Long-term Outcomes of Carotid Artery Stenting: A Single-center Experience

• Published in: Neurologia medico-chirurgica Vol. 60; no. 3; pp. 121 - 125
• Main Authors: SHINTAI, Kazunori, KOJIMA, Takao, SEKI, Yukio, FUSE, Yutaro
• Format: Journal Article
• Language: English
• Published: Japan The Japan Neurosurgical Society 2020; THE JAPAN NEUROSURGICAL SOCIETY; Japan Science and Technology Agency
• Subjects: Aged; Angioplasty; Carotid arteries; Carotid artery; carotid artery stenting; Carotid Stenosis - diagnosis; Carotid Stenosis - mortality; Carotid Stenosis - surgery; Embolism; Female; Humans; Implants; Ischemia; long-term; Male; Original; real-world setting; Recurrence; Restenosis; Retrospective Studies; Stenosis; Stents; Stroke; Time Factors; Treatment Outcome; carotid artery stenting; restenosis; real-world setting; stenosis; long-term
• ISSN: 0470-8105; 1349-8029; 1349-8029
• DOI: 10.2176/nmc.oa.2019-0192

The long-term prophylactic effect of carotid artery stenting (CAS) remains incompletely elucidated. We evaluated outcomes of CAS at our institution to determine the safety and efficacy of CAS in real-world settings. We retrospectively analyzed 73 patients who underwent CAS from 2006 to 2013. Periprocedural results were compared between asymptomatic and symptomatic carotid stenosis groups. The primary endpoint was a composite of ipsilateral stroke, death, and carotid artery restenosis beyond 30 days and within 5 years after the first procedure. The average age was 72.2 years with a majority of male subjects (84.9%). Twenty-seven patients (37%) were asymptomatic. Incidence of periprocedural adverse events and mRS ≤2 at 30 days after CAS were not significantly different between groups (P = 0.14 and 0.07, respectively). CAS was unsuccessful in three patients and one post-procedural minor stroke occurred. Therefore, 69 patients were included in the long-term study. The rate of occurrence of the primary endpoint was 21.7%. Ipsilateral ischemic stroke occurred in one patient, which was due to cardiogenic embolus. Nine patients died, and cancer was the most frequent cause. Five in-stent restenoses were observed. All patients with restenosis underwent additional CAS without any occurrence of stroke. This study revealed the safety and long-term efficacy of CAS in a real-world setting. Routine follow-up is also important for detecting carotid artery restenosis.