Carotid artery stenting without post-stenting balloon dilatation - PubMed (original) (raw)
Carotid artery stenting without post-stenting balloon dilatation
Atsushi Ogata et al. J Neurointerv Surg. 2014 Sep.
Free PMC article
Abstract
Purpose: To evaluate the clinical outcome and MRI findings after carotid artery stenting (CAS) without post-dilatation.
Methods: Between May 2005 and April 2012, a total of 169 consecutive patients (61.4% symptomatic) underwent 176 CAS procedures performed with an embolic protection device (GuardWire, n=116; FilterWire EZ, n=60). All stents were deployed without post-dilatation. Periprocedural complications and mid-term outcomes were analyzed.
Results: The stroke rate was 2.3% within 30 days post-CAS (asymptomatic patients 1.5%; symptomatic patients 2.8%). Cerebral infarction occurred in one asymptomatic patient (1.5%) and one symptomatic patient (0.9%). Intracranial hemorrhage occurred in two symptomatic patients (1.9%). Post-CAS diffusion-weighted imaging (DWI) revealed a high-intensity area in 26 of 176 procedures (14.8%). Ipsilateral stroke after 31 days occurred in two patients (1.1%) and restenosis occurred in six (3.4%). A post-CAS comparison of the embolic protection devices revealed no difference in stroke incidence within 30 days and in DWI high-intensity area.
Conclusions: Our CAS procedure without post-dilatation is feasible, safe and associated with a low incidence of stroke and restenosis.
Keywords: Artery; Cervical; Intervention; Stent; Technique.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Figures
Figure 1
An octogenarian with symptomatic carotid artery stenosis who underwent carotid artery stenting using the GuardWire system. (A) Black blood T1-weighted MRI showing a high-intensity plaque lesion in the right internal carotid artery (white arrow). (B) Angiogram of the right common carotid artery showing severe stenosis of the internal carotid artery with a long lesion. (C) Post-procedural angiogram of the right common carotid artery (pre-dilatation with 4×30 mm balloon and stent deployment with 10×24 mm carotid Wallstent) showing improvement of the internal carotid artery stenosis.
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