Efficacy and safety of carotid artery stenting for stroke preve

Abstract

Background: Extracranial carotid artery stenosis is a leading cause of ischemic stroke. Carotid endarterectomy (CEA) is the gold-standard management for secondary stroke prevention yet carotid artery stenting (CAS) has emerged in the last decade as an alternative for high surgical risk patients. Purpose: To assess the effectiveness, safety and outcomes of CAS in extra-cranial carotid artery stenosis patients in terms of stroke prevention. Methodology: Twenty patients with symptomatic and asymptomatic carotid artery stenosis were enrolled between 2012 and 2014. Symptomatic patients were eligible for CAS if the internal carotid artery stenosis was ⩾50%, while 80% was the threshold in asymptomatic patients. Results: Symptomatic patients enrolled were fifteen (75%) and asymptomatic patients were five (25%). Two patients (10%) were excluded owing to target vessel occlusion. One patient (5%) underwent bilateral CAS. The procedure was successful in eighteen patients (90%) one of them complicated by distal embolization (5%). One patient died secondary to associated chronic liver disease (5%), otherwise no stroke or death was recorded along the follow-up period. Conclusion: Careful patient selection and technique optimization are crucial to improve clinical outcome which make it a safe alternative for surgical revascularization in stroke prevention.

Keywords

• Stroke
• Prevention
• Carotid
• Stenting
• Endarterectomy