Carotid arterial stent placement: Results and follow-up in 53 patients

PURPOSE: To describe the results, complications, and follow-up data after s tent placement for occlusive internal carotid arterial disease and to compa re the results with those in the literature. MATERIALS AND METHODS: Carotid arterial stent placement was attempted in 57 arteries in 53 patients. Thirty-six (68%) of 53 patients were symptomatic. Forty-two (79%) of 53 patients had one to three clinically important comor bidities and were considered at high risk. All patients underwent pre- and postprocedural independent neurologic examinations. Follow-up consisted of serial duplex ultrasonography and clinical assessment. RESULTS: The immediate technical success rate of stent deployment was 97%. Periprocedurally, three (three [5%] of 57 interventions) transient ischemic attacks and three (three [5%] of 57 interventions) minor strokes occurred, Two deaths occurred in the first 30 days (one myocardial infarction, one r enal failure). One ipsilateral major stroke occurred 3 weeks after the proc edure. The 30-day ipsilateral major stroke and death rate was 5% (three of 57 interventions). At 30 days, one of three patients with minor stroke had mild residual dysphasia. Treatment remained clinically successful in 48 (96 %) of 50 patients. The restenosis rate was 4% (two patients), CONCLUSION: Carotid arterial stent placement in a high-risk population has morbidity and mortality rates comparable to those of carotid endarterectomy in a lower risk population. Carotid arterial stent placement can be perfor med with a low restenosis rate.