Carotid artery stenting in patients with high-risk anatomy for carotid endarterectomy

G. Dangas, Jr Laird J.R., R. Mehran, L. F. Satler, A. J. Lansky, G. Mintz, L. H. Monsein, R. Laureno, M. B. Leon

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Purpose: To report the results of carotid artery stenting (CAS) in patients considered to have high-risk anatomical characteristics for carotid endarterectomy. Methods: CAS was performed in 39 carotid arteries of 37 consecutive patients (26 men; mean age 72 ± 8 years, range 56-88) who met the criteria for high-risk surgical anatomy: previous ipsilateral carotid endarterectomy (20/39, 51.3%), common carotid bifurcation above the mandibular angle (5/39, 12.8%), contralateral carotid artery occlusion (15/39, 38.5%), or previous radiation therapy to the neck (1/39, 2.6%). Palmaz, Integra, or Wallstents were deployed via a percutaneous femoral artery access. Independent neurological evaluation was performed at specified time points, and a dedicated committee adjudicated all clinical events. Results: Procedural success was 100%, with no major in-hospital complications. Neurological events were rare. Only 1 (2.6%) transient ischemic attack occurred prior to discharge; at 30 days, 1 (2.6%) additional minor stroke had been observed, giving a 2.6% cumulative 30-day "death plus any stroke" rate. Over a mean 11 ± 6-month follow-up, 2 (5.4%) patients died of nonneurological causes, but there were no strokes. Conclusions: CAS is a viable endovascular revascularization technique that can be performed safely and effectively in patients with high-risk anatomy for carotid endarterectomy.

Original languageEnglish (US)
Pages (from-to)39-43
Number of pages5
JournalJournal of Endovascular Therapy
Volume8
Issue number1
DOIs
StatePublished - 2001
Externally publishedYes

Fingerprint

Carotid Endarterectomy
Carotid Arteries
Anatomy
Stroke
Endovascular Procedures
Transient Ischemic Attack
Femoral Artery
Neck
Radiotherapy

Keywords

  • Angioplasty
  • Carotid artery
  • Integra
  • Occlusive disease
  • Palmaz
  • Stroke
  • Wallstent

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Dangas, G., Laird J.R., J., Mehran, R., Satler, L. F., Lansky, A. J., Mintz, G., ... Leon, M. B. (2001). Carotid artery stenting in patients with high-risk anatomy for carotid endarterectomy. Journal of Endovascular Therapy, 8(1), 39-43. https://doi.org/10.1583/1545-1550(2001)008<0039:CASIPW>2.0.CO;2

Carotid artery stenting in patients with high-risk anatomy for carotid endarterectomy. / Dangas, G.; Laird J.R., Jr; Mehran, R.; Satler, L. F.; Lansky, A. J.; Mintz, G.; Monsein, L. H.; Laureno, R.; Leon, M. B.

In: Journal of Endovascular Therapy, Vol. 8, No. 1, 2001, p. 39-43.

Research output: Contribution to journalArticle

Dangas, G, Laird J.R., J, Mehran, R, Satler, LF, Lansky, AJ, Mintz, G, Monsein, LH, Laureno, R & Leon, MB 2001, 'Carotid artery stenting in patients with high-risk anatomy for carotid endarterectomy', Journal of Endovascular Therapy, vol. 8, no. 1, pp. 39-43. https://doi.org/10.1583/1545-1550(2001)008<0039:CASIPW>2.0.CO;2
Dangas, G. ; Laird J.R., Jr ; Mehran, R. ; Satler, L. F. ; Lansky, A. J. ; Mintz, G. ; Monsein, L. H. ; Laureno, R. ; Leon, M. B. / Carotid artery stenting in patients with high-risk anatomy for carotid endarterectomy. In: Journal of Endovascular Therapy. 2001 ; Vol. 8, No. 1. pp. 39-43.
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AU - Satler, L. F.

AU - Lansky, A. J.

AU - Mintz, G.

AU - Monsein, L. H.

AU - Laureno, R.

AU - Leon, M. B.

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N2 - Purpose: To report the results of carotid artery stenting (CAS) in patients considered to have high-risk anatomical characteristics for carotid endarterectomy. Methods: CAS was performed in 39 carotid arteries of 37 consecutive patients (26 men; mean age 72 ± 8 years, range 56-88) who met the criteria for high-risk surgical anatomy: previous ipsilateral carotid endarterectomy (20/39, 51.3%), common carotid bifurcation above the mandibular angle (5/39, 12.8%), contralateral carotid artery occlusion (15/39, 38.5%), or previous radiation therapy to the neck (1/39, 2.6%). Palmaz, Integra, or Wallstents were deployed via a percutaneous femoral artery access. Independent neurological evaluation was performed at specified time points, and a dedicated committee adjudicated all clinical events. Results: Procedural success was 100%, with no major in-hospital complications. Neurological events were rare. Only 1 (2.6%) transient ischemic attack occurred prior to discharge; at 30 days, 1 (2.6%) additional minor stroke had been observed, giving a 2.6% cumulative 30-day "death plus any stroke" rate. Over a mean 11 ± 6-month follow-up, 2 (5.4%) patients died of nonneurological causes, but there were no strokes. Conclusions: CAS is a viable endovascular revascularization technique that can be performed safely and effectively in patients with high-risk anatomy for carotid endarterectomy.

AB - Purpose: To report the results of carotid artery stenting (CAS) in patients considered to have high-risk anatomical characteristics for carotid endarterectomy. Methods: CAS was performed in 39 carotid arteries of 37 consecutive patients (26 men; mean age 72 ± 8 years, range 56-88) who met the criteria for high-risk surgical anatomy: previous ipsilateral carotid endarterectomy (20/39, 51.3%), common carotid bifurcation above the mandibular angle (5/39, 12.8%), contralateral carotid artery occlusion (15/39, 38.5%), or previous radiation therapy to the neck (1/39, 2.6%). Palmaz, Integra, or Wallstents were deployed via a percutaneous femoral artery access. Independent neurological evaluation was performed at specified time points, and a dedicated committee adjudicated all clinical events. Results: Procedural success was 100%, with no major in-hospital complications. Neurological events were rare. Only 1 (2.6%) transient ischemic attack occurred prior to discharge; at 30 days, 1 (2.6%) additional minor stroke had been observed, giving a 2.6% cumulative 30-day "death plus any stroke" rate. Over a mean 11 ± 6-month follow-up, 2 (5.4%) patients died of nonneurological causes, but there were no strokes. Conclusions: CAS is a viable endovascular revascularization technique that can be performed safely and effectively in patients with high-risk anatomy for carotid endarterectomy.

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