| ORIGINAL ARTICLE |
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| Year : 2016 | Volume
: 53
| Issue : 4 | Page : 211-218 |
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Carotid artery stenting in high-risk patients: a single-center experience
Mohamed K Elewa MD
Department of Neurology, Ain Shams University Hospitals, Ain Shams University, Cairo, Egypt
Correspondence Address:
Mohamed K Elewa
Department of Neurology, Ain Shams University Hospitals, Ain Shams University, 38 El-Abbasia, Cairo 11566
Egypt
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1110-1083.202380
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Background
Carotid artery stenting (CAS) is a valid alternative to carotid endarterectomy in selected patients. Periprocedural risk of complications is the main determinant for CAS validity. Certain patients’ features may increase the risk of complication.
Purpose
To assess the management and outcome of the CAS in high-risk patient population.
Patients and methods
Clinical, treatment, and outcome variables of consecutive high-risk CAS candidates between January 2011 and June 2016 in one center were analyzed.
Results
Among 29 patients, 21 patients had successful CAS, and only one (3.45%) patient had minor periprocedural stroke. In total, six (20.69%) patients were shifted to carotid endarterectomy, and two (6.90%) patients were managed with medical treatment. Regression analysis showed that bovine arch was independent predictor of CAS infeasibility (P=0.006). The mean follow-up duration was 21.38±15 months. Follow-up duration passed uneventfully.
Conclusion
CAS in high-risk patients appears to be technically safe. The adverse outcome in high-risk patients is low and accepted. The morbidity and mortality is avoidable with better patient selection and the avoidance of aggressive manipulation whenever possible. CAS should be avoided in patients with certain anatomic risk factors such as type III arch and bovine arch. |
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