Carotid artery stenosis: Routine predilatation or direct stenting?
Journal
Annals of the College of Surgeons of Hong Kong
Journal Volume
8
Journal Issue
4
Pages
129-134
Date Issued
2004
Author(s)
Abstract
Stenting is a potential alternative treatment for carotid artery stenosis. Direct stenting may, theoretically, reduce the risk of embolism by minimizing plaque manipulation before tissue scaffolding is achieved. The results of direct carotid stenting are reported and compared with those of stenting with predilatation. One hundred and seventy-four carotid artery stenoses were treated from July 1998 to February 2002, with 84 lesions directly stented (Group 1) and the other 90 lesions stented after predilatation (Group 2). The criteria for direct stenting were minimal luminal diameter (MLD) > 1 mm and no visible thrombus angiographically. Technical success rates of the two groups were both 100%, without any cross-over. Reference vessel diameter and lesion length did not differ between the two groups. In Group 1, diameter stenosis was lower (79 ± 8 vs 92 ± 7%, P < 0.001) and MLD was larger (1.1 ± 0.5 vs 0.4 ± 0.4 mm, P < 0.001) than that in Group 2, but the final MLD (4.7 ± 0.9 vs 4.7 ± 0.9 mm, P = 0.94) of the two groups were not statistically different. The periprocedural ipsilateral stroke or death rates were also similar in the two groups (2/84 vs 4/90, P = 0.68). It was concluded that if the MLD of carotid stenosis is larger than 1 mm and no thrombus is present, direct stenting could be carried out safely with results comparable to that of stenting after predilatation.
SDGs
Other Subjects
acetylsalicylic acid; clopidogrel; heparin; ticlopidine; adult; aged; artery diameter; artery dilatation; artery lesion; artery thrombosis; article; carotid arteriography; carotid artery obstruction; controlled study; disease severity; female; human; intermethod comparison; major clinical study; male; perioperative period; safety; stent; stroke; surgical mortality; surgical technique; treatment indication; treatment outcome
Type
journal article