Carotid artery stenting in a single center, single operator, single type of device and 15 years of follow-up

Mayoral Campos, Victoria ; Guirola Órtiz, José Andrés ; Tejero Juste, Carlos ; Gimeno Peribáñez, María José (Universidad de Zaragoza) ; Serrano, Carolina (Universidad de Zaragoza) ; Pérez Lázaro, Cristina (Universidad de Zaragoza) ; de Blas Giral, Ignacio (Universidad de Zaragoza) ; de Gregorio Ariza, Miguel Ángel (Universidad de Zaragoza)

Resumen: Background: Revascularization with carotid stent (CAS) is considered the therapeutic alternative to endarterectomy (CEA). However, its role compared to CEA remains questioned, mainly due of the heterogeneity of long-term results. The objective of this study was to report the efficacy and durability of CAS in terms of stroke prevention in a “real world experience”.
Method: This was a single-center retrospective analysis of 344 patients treated with CAS between January 2001 and December 2015.
The primary outcome of the trial was stroke, myocardial infarction, or death during a periprocedural period or
any stroke event over a 15-year follow-up. The secondary aim was to identify risk factors for 30-day complications, long-term neurological complications, and intra-stent restenosis.
Results: The primary composite end point (any stroke, myocardial infarction, or death during the periprocedural period) was 2.3%. The use of an EPD was protective against major complications.
Long-term follow-up was achieved in 294 patients (85,5%) with a median of 50 months (range 0-155 months). Fifty-six (16,3%) died within this period, most commonly of nonvascular causes (4 patients had stroke-related deaths). During the follow-up period, 8 strokes and 3 TIAs were diagnosed (3.2%).
ISR determined by sequential ultrasound was assessed in 4.4% of the patients and remained asymptomatic in all but 2 patients (0.6%). All patients with restenosis underwent revascularization with balloon angioplasty.
Conclusion: The long-term follow-up results of our study validate CAS as a safe and durable procedure with which to prevent ipsilateral stroke, with an acceptable rate of restenosis, recurrence and mortality.

Idioma: Inglés

DOI: 10.1186/s42155-018-0008-2

Año: 2018

Publicado en: CVIR endovascular 1, 3 (2018), [8 pp.]
ISSN: 2520-8934

Tipo y forma: Article (Published version)

Área (Departamento): Área Radiol. y Medicina Física (Dpto. Pediatría Radiol.Med.Fís)
Área (Departamento): Área Sanidad Animal (Dpto. Patología Animal)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
Área (Departamento): Área Medicina y Cirugía Animal (Dpto. Patología Animal)