BACKGROUND: While carotid endarterectomy continues to be the gold stan
dard of treatment for most patients with significant carotid artery di
sease, there are cases where lesion or anatomy-related factors create
situations less than ideal for conventional surgery. Other therapeutic
modalities, such as endoluminal stenting, may represent reasonable op
tions for such patients. METHODS: Thirty-three patients with 70% or gr
eater internal carotid artery lesions were treated by endovascular ste
nt placement from July 1994 through June 1996. Indications included tr
ansient ischemic attacks in 20 and previous stroke in 4; and 9 were as
ymptomatic. RESULT: Stents were placed successfully in all instances.
Mortality and stroke rates were zero. All patients remained asymptomat
ic during follow-up (mean 8 months), and stent patency by duplex ultra
sound has been 100%. A single instance of intrastent restenosis has be
en observed. CONCLUSIONS: Endoluminal stenting is an investigational t
echnique of unproven efficacy and longterm durability. Yet it appears
technically feasible, and possibly reasonable, as an alternate option
for cases unfavorable for standard surgery. (C) 1997 by Excerpta Medic
a, Inc.