TITLE

Carotid Angioplasty and Stenting Is a Safe and Durable Procedure in a Community Hospital

AUTHOR(S)
Friedell, Mark L.; Sandler, Bryan J.; Andriole, Joseph G.; Martin, Samuel P.; Cohen, Michael J.; Horowitz, John D.
PUB. DATE
June 2007
SOURCE
American Surgeon;Jun2007, Vol. 73 Issue 6, p543
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Carotid angioplasty and stenting (CAS) has been touted as a reasonable alternative to carotid endarterectomy (CEA) for high-risk surgical candidates. Several published CAS series, primarily from academic centers, show immediate results approaching those of CEA. However, very little is known about long-term results with CAS, particularly in the community hospital setting. Therefore, we retrospectively reviewed our CAS experience. From February 1999 to July 2003, 44 consecutive patients underwent placement of 46 stents. The mean patient age was 73 years, and 57 per cent were men. Most patients were asymptomatic (74%). High-risk categories included prior CEA (71%), other anatomic risks (13%), and/or significant medical comorbidities (16%). Technical success was achieved in all 46 cases. At 30 days, there were no deaths and one stroke, giving a combined stroke/mortality of 2 per cent. Clinical follow-up was obtained on all 44 patients at a mean follow-up of 42 months. Duplex scans performed on 44 stents (96%), at a mean follow-up of 40 months, demonstrated four 60 per cent to 79 per cent recurrent stenoses. CAS in a community hospital can have a 30-day stroke/mortality equivalent to CEA. The procedure is durable, with no critical (80%-99%) carotid restenoses and no stroke or transient ischemic attacks referable to a stented carotid artery in long-term follow-up.
ACCESSION #
25515605

 

Related Articles

  • Controversies in neurology: asymptomatic carotid stenosis-intervention or just stick to medical therapy. The argument for carotid endarterectomy. Hirt, Liam; Halliday, Alison // Journal of Neural Transmission;Apr2011, Vol. 118 Issue 4, p631 

    Patients with a significant carotid stenosis are at an increased risk of suffering from a potentially fatal or disabling stroke. The current management strategies available to a patient with an asymptomatic carotid stenosis are either medical therapy alone, or in combination with either carotid...

  • NASCET, ECST, ACAS -- Who Should Undergo Operation? Lam, Everett Y.; Moneta, Gregory L. // Vascular Surgery;Jan/Feb2000, Vol. 34 Issue 1, p1 

    Discusses the effectiveness of surgical procedure carotid endarterectomy. Improved neurological outcome after carotid arterectomy for patients with symptomatic and asymptomatic carotid stenosis; Information on antiplatelet agents, carotid angioplasty and stent placement used to alter the...

  • Carotid artery stenting with distal filter protection: single-center experience in high-surgical-risk patients. Knur, Rainer // Heart & Vessels;Mar2011, Vol. 26 Issue 2, p125 

    Carotid artery stenting (CAS) is an efficient alternative procedure for the treatment of high-surgical-risk patients with symptomatic and asymptomatic carotid stenosis. The use of cerebral protection systems might decrease procedural risk of stroke and death. We report our initial experience...

  • Early and Late Results of CAS in the Italian Registry: What Are the Limits of Registry Data? Biasi, G. M.; Deleo, G.; Inglese, L.; Cremonesi, A.; Froio, A.; Camesasca, V.; Piazzoni, C.; Liloia, A. // Vascular;Nov2005 Supplement, Vol. 13, pS151 

    This article presents information on a study that examined carotid stenting (CS) procedures performed by different specialists with different techniques. The article lists the variety of specialists involved in the study. Information is presented on the number of CS procedures performed. The...

  • Comparison between Carotid Stenting and Carotid Endarterectomy in Early Outcome. Kovačić, Slavica; Kovačević, Miljenko; Strenja-Linić, Ines; Budiselić, Berislav; Knežević, Siniša // Collegium Antropologicum;Jun2011 Supplement, Vol. 35, p271 

    Carotid artery stenting (CAS) is a widely used method in prevention of stroke for carotid artery stenosis as an alternative to surgical treatment. Initial studies reveal higher morbidity and mortality rates for CAS than acceptable standards for carotid endarterectomy (CEA). The aim of this study...

  • Carotid Endoarterectomy (CEA) and Carotid Artery Stenting (CAS): prophylaxis and treatment of stroke. Russo, R. // BMC Geriatrics;2010 Supplement 1, Vol. 10, Special section p1 

    Background The endoarterectomy (CEA) has always been considered the gold standard for significant carotid stenosis treatment (obstruction of the lumen ≥ 70%). The stenting (CAS) techniques have made great steps forward in recent years and it is considered more and more a valid alternative...

  • Current Status of Carotid Stenting. Ji Sun Kim; Mukherjee, Debabrata // Current Vascular Pharmacology;Apr2008, Vol. 6 Issue 2, p143 

    Stroke is the third most common cause of death worldwide following ischemic heart disease and cancer and the number one condition associated with permanent disability. In Western countries, the yearly incidence of stroke is ~ 0.2% of the population and the number of stroke-related death is...

  • Carotid Stenting at the Crossroads: Practice Makes Perfect, But Some May Be Practicing Too Much (and Not Enough). Halm, Ethan A. // JAMA: Journal of the American Medical Association;9/28/2011, Vol. 306 Issue 12, p1378 

    The author looks at the benefits and risks linked with carotid angioplasty with stenting (CAS). He references a study by B. K. Nallamothu et al. on the relationship between operator experience and 30-day mortality rates after CAS published within the issue. He cites that the study found that...

  • A computational model study of the influence of the anatomy of the circle of willis on cerebral hyperperfusion following carotid artery surgery.  // BioMedical Engineering OnLine;2011, Vol. 10 Issue 1, p84 

    The article presents information on a study which examines how the anatomy of the Circle of Willis (CoW) or cerebral arterial circle of the cerebral circulation affects post-carotid artery surgery (CAS) cerebral hyperperfusion. CAS is performed for the treating severe carotid artery stenosis and...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics