Journal ArticleDOI
Updated review of the global carotid artery stent registry.
TLDR
The periprocedure risks for major and minor strokes and death are generally acceptable at this early stage of development and have shown an improvement with technological developments, including distal embolic protection.Abstract:
The purpose of this article was to review and update the current status of carotid artery stent placement in the world. Surveys of major interventional centers in Europe, North and South America, and Asia were initially completed in June 1997. Subsequent updates from these 24 centers in addition to 29 new centers have been obtained to bring up to date the information. The survey asked the various questions regarding the patients enrolled, procedure techniques, and results of carotid stenting, including complications and restenosis. The total number of endovascular carotid stent procedures that have been performed worldwide to date included 12,392 procedures involving 11,243 patients. There was a technical success of 98.9% with 12,254 carotid arteries treated. Complications that occurred during the carotid stent placement or within a 30-day period following placement were recorded. Overall, there was transient ischemic attack rate of 3.07%, minor strokes of 2.14%, major strokes of 1.20%, and procedure-related deaths of 0.64%. The combined minor and major strokes and procedure-related death rate was 3.98% based on procedure number. With nonprocedure-related death rate of 0.77%, the total stroke and death rate was 4.75%. Subsets of questions were directed at the new use of distal embolic protection devices; there were 6,753 cases done without protection and which incurred a 5.29% rate of strokes and procedure-related deaths. In the 4,221 cases with cerebral protection, there was a 2.23% rate of strokes and procedure-related deaths. Restenosis rates of carotid stenting have been 2.7%, 2.6%, and 2.4% at 1, 2, and 3 years, respectively. The rate of neurologic events after stent placement has been 1.2%, 1.3%, and 1.7% at 1, 2, and 3 years, respectively. Endovascular stent treatment of carotid artery atherosclerotic disease is growing as an alternative for vascular surgery, especially for patients who are high risk for standard carotid endarterectomy. The periprocedure risks for major and minor strokes and death are generally acceptable at this early stage of development and have shown an improvement with technological developments, including distal embolic protection. Catheter Cardiovasc Interv 2003;60:259-266read more
Citations
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Journal ArticleDOI
Endarterectomy versus stenting in patients with symptomatic severe carotid stenosis
Jean-Louis Mas,Gilles Chatellier,Bernard Beyssen,Alain Branchereau,Thierry Moulin,Jean-Pierre Becquemin,Vincent Larrue,Michel Lievre,Didier Leys,Jean-François Bonneville,Jacques Watelet,Jean-Pierre Pruvo,Jean-François Albucher,Alain Viguier,Philippe Piquet,Pierre Garnier,Fausto Viader,Emmanuel Touzé,Maurice Giroud,Hassan Hosseini,Jean-Christophe Pillet,Pascal Favrole,Jean-Philippe Neau,Xavier Ducrocq,S Investigators,Abstr Act +25 more
TL;DR: In this study of patients with symptomatic carotid stenosis of 60% or more, the rates of death and stroke at 1 and 6 months were lower with endarterectomy than with stenting.
Journal ArticleDOI
2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: Executive summary: A report of the American college of cardiology foundation/american heart association task force on practice guidelines, and the American stroke association, American association of neuroscience nurses
Thomas G. Brott,Jonathan L. Halperin,Suhny Abbara,J. Michael Bacharach,John D. Barr,Ruth L. Bush,Christopher U. Cates,Mark A. Creager,Susan B. Fowler,Gary Friday,Vicki S. Hertzberg,E. Bruce McIff,Wesley S. Moore,Peter D. Panagos,Thomas S. Riles,Robert H. Rosenwasser,Allen J. Taylor +16 more
Journal ArticleDOI
Updated Society for Vascular Surgery guidelines for management of extracranial carotid disease
TL;DR: Recommendations are made using the GRADE (Grades of Recommendation Assessment, Development and Evaluation) system, as has been done with other Society for Vascular Surgery guideline documents.[corrected] the perioperative risk of stroke and death in asymptomatic patients must be <3% to ensure benefit for the patient.
Journal ArticleDOI
2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease: Executive Summary
Thomas G. Brott,Jonathan L. Halperin,Suhny Abbara,J. Michael Bacharach,John D. Barr,Ruth L. Bush,Christopher U. Cates,Mark A. Creager,Susan B. Fowler,Gary Friday,Vicki S. Hertzberg,E. Bruce McIff,Wesley S. Moore,Peter D. Panagos,Thomas S. Riles,Robert H. Rosenwasser,Allen J. Taylor +16 more
TL;DR: Recommendations for Management of Diabetes Mellitus in Patients With Atherosclerosis of the Extracranial Carotid or Vertebral Arteries and for Control of Hyperlipidemia.
Journal ArticleDOI
Carotid artery stenting is associated with increased complications in octogenarians: 30-day stroke and death rates in the CREST lead-in phase
Robert W. Hobson,Virginia J. Howard,Gary S. Roubin,Thomas G. Brott,Robert D. Ferguson,Jeffrey J. Popma,Darlene L. Graham,George Howard +7 more
TL;DR: Interim results from the lead-in phase of CREST show that the periprocedural risk of stroke and death after CAS increases with age in the course of a credentialing registry.
References
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Journal ArticleDOI
Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis
Barnett Hjm.,D W Taylor,Richard Haynes,David L. Sackett,Sydney J. Peerless,Gary G. Ferguson,Allan J. Fox,R N Rankin,Vladimir Hachinski,Wiebers Do,Michael Eliasziw +10 more
TL;DR: Carotid endarterectomy is highly beneficial to patients with recent hemispheric and retinal transient ischemic attacks or nondisabling strokes and ipsilateral high-grade stenosis of the internal carotid artery.
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TL;DR: A 15-item neurologic examination stroke scale for use in acute stroke therapy trials was designed and interrater reliability for the scale was found to be high, and test-retest reliability was also high, suggesting acceptable examination and scale validity.
Journal ArticleDOI
Immediate and Late Clinical Outcomes of Carotid Artery Stenting in Patients With Symptomatic and Asymptomatic Carotid Artery Stenosis A 5-Year Prospective Analysis
Gary S. Roubin,Gishel New,Sriram S. Iyer,Jiri J. Vitek,Nadim Al-Mubarak,Ming W. Liu,Jay S. Yadav,Camilo R. Gomez,Richard E. Kuntz +8 more
TL;DR: The purpose of this study was to determine short- and long-term outcomes in the largest prospective cohort of carotid stenting patients, and found that the best predictor of 30-day stroke and death was age ≥80 years.
Journal ArticleDOI
Global experience in cervical carotid artery stent placement
Michael H. Wholey,Mark H. Wholey,Klaus Mathias,Gary S. Roubin,Edward B. Diethrich,Michel Henry,Steven R. Bailey,Patrice Bergeron,Gerald Dorros,Eles G,P Gaines,Camilo R. Gomez,Bruce H. Gray,J Guimaraens,Randall T. Higashida,D S Ho,Barry T. Katzen,A Kambara,Vijay Kumar,Jean Claude Laborde,Martin B. Leon,Lim Mc,Hugo F. Londero,Juan E. Mesa,A Musacchio,Subbarao Myla,S. R. Ramee,A Rodriquez,Kenneth Rosenfield,N Sakai,Fayaz A. Shawl,Horst Sievert,George P. Teitelbaum,Jacques Theron,P Vaclav,Vozzi C,Jay S. Yadav,S I Yoshimura +37 more
TL;DR: The periprocedure risks for major and minor strokes and death are generally acceptable at this early stage of development and have not changed significantly since the first survey results.
Journal ArticleDOI
Carotid artery stenosis: treatment with protected balloon angioplasty and stent placement.
TL;DR: Endovascular treatment can be considered for all types of carotid artery stenosis by means of angioplasty with cerebral protection and stent placement, andStent placement has eliminated the risk of immediate dissection and reduction of delayed restenosis.
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