Global experience in cervical carotid artery stent placement

The purpose of this article is to review and update the current status of c arotid artery stent placement in the world. Surveys to major interventional centers in Europe, North and South America, and Asia were initially comple ted in June 1997. Subsequent information from these 24 centers in addition to 12 new centers has been obtained to update the information. The survey a sked the various questions regarding the patients enrolled, procedure techn iques, and results of carotid stenting, including complications and resteno sis. The total number of endovascular carotid stent procedures that have be en performed worldwide to date included 5,210 procedures involving 4,757 pa tients. There was a technical success of 98.4% with 5,129 carotid arteries treated. Complications that occurred during the carotid stent placement or within a 30-day period following placement were recorded. Overall, there we re 134 transient ischemic attacks (TIAs) for a rate of 2.82%. Based on the total patient population, there were 129 minor strokes with a rate of occur rence of 2.72%. The total number of major strokes was 71 for a rate of 1.49 %. There were 41 deaths within a 30-day postprocedure period resulting in a mortality rate of 0.86%. The combined minor and major strokes and procedur e-related death rate was 5.07%. Restenosis rates of carotid stenting have b een 1.99 % and 3.46% at 6 and 12 months, respectively. The rate of neurolog ic events after stent placement has been 1.42% at 6-12-month follow-up. End ovascular stent treatment of carotid artery atherosclerotic disease is grow ing as an alternative for vascular surgery, especially for patients that ar e high risk for standard carotid endarterectomy. The periprocedure risks fo r major and minor strokes and death are generally acceptable at this early stage of development and have not changed significantly since the first sur vey results. (C) 2000 Wiley-Liss, Inc.