Published Online
on October 28, 2004

A more recent version of this article appeared on December 1, 2004

This Article Full Text (PDF) All Versions of this Article: 35/12/2862    most recent 01.STR.0000147714.19871.45v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sztriha, L. K. Articles by Vécsei, L. Search for Related Content PubMed PubMed Citation Articles by Sztriha, L. K. Articles by Vécsei, L. Related Collections Carotid Stenosis Angioplasty and Stenting

Submitted on June 14, 2004
Revised on August 29, 2004
Accepted on September 6, 2004

Favorable Early Outcome of Carotid Artery Stenting Without Protection Devices

László K. Sztriha MD^*; Erika Vörös MD, PhD; Katalin Sas MD; Réka Szentgyörgyi MD, PhD; Anna Pócsik MD; Pál Barzó MD, PhD; Péter Szikra BSc; Attila Makai MD; Alex Szólics; Péter Elek MD; László Rudas MD, PhD, DSc; and László Vécsei MD, PhD, DSc

From the Departments of Neurology (L.K.S., K.S., L.V.), Radiology (E.V., R.S., A.P., P.S., A.S.), Neurosurgery (P.B., P.E.), and the Medical Intensive Care Unit (A.M., L.R.), Cardiology Center, Albert Szent-Györgyi Medical and Pharmaceutical Center, University of Szeged; and the Neurology Research Group of the Hungarian Academy of Sciences and University of Szeged (L.V.), Szeged, Hungary.

^* To whom correspondence should be addressed. E-mail: sztriha{at}nepsy.szote.u-szeged.hu.

Background and Purpose--Protection devices are increasingly used in carotid artery stenting. However, no randomized trial has been conducted to evaluate the efficacy of such devices, and arguments have also been formulated against their routine use. We set out to investigate the complication rates associated with carotid artery stenting performed without protection devices. Applicability of covered stents in the carotid system was also evaluated.

Methods--Between January 2001 and July 2003, 245 consecutive patients (260 hemispheres) underwent carotid artery stenting. No protection devices were applied. Covered stents were implanted in 31 (12.1%) cases. The incidence of complications during the intervention and the subsequent 30-day follow-up period was recorded.

Results--The technical success rate was 98.8%. One postprocedural nonneurological death (0.4%) occurred. Neurological complications (inclusive of transient ischemic attacks) were observed in 14 cases (5.4%). The rate of major complications (death, major stroke, and myocardial infarction) was 1.6% among the symptomatic and 1.5% among the asymptomatic cases. The rate of minor strokes was 3.2% in the symptomatic and 1.5% in the asymptomatic group. Of the neurological complications, 64.3% occurred postprocedurally. No ipsilateral neurological complications were detected in the subgroup treated with covered stents.

Conclusions--Carotid artery stenting without protection devices appears to be safe. Most of the neurological complications could not have been prevented with protection devices, because they occurred after the intervention. The application of covered stents may reduce the rate of embolization-related complications in the periprocedural period.

Key words: carotid arteries • embolism • protective devices • stents

This article has been cited by other articles:

				F. Perona, G. Castellazzi, L. Valvassori, E. Boccardi, L. de Girolamo, G. P. Cornalba, and K. Kandarpa Safety of Unprotected Carotid Artery Stent Placement in Symptomatic and Asymptomatic Patients: A Retrospective Analysis of 30-day Combined Adverse Outcomes Radiology, January 1, 2009; 250(1): 178 - 183. [Abstract] [Full Text] [PDF]

				F. Verzini, P. De Rango, G. Parlani, G. Panuccio, and P. Cao Carotid Artery Stenting: Technical Issues and Role of Operators' Experience Perspectives in Vascular Surgery and Endovascular Therapy, September 1, 2008; 20(3): 247 - 257. [Abstract] [PDF]

				M. Schillinger, M. Gschwendtner, B. Reimers, J. Trenkler, L. Stockx, J. Mair, S. Macdonald, F. Karnel, K. Huber, and E. Minar Does Carotid Stent Cell Design Matter? Stroke, March 1, 2008; 39(3): 905 - 909. [Abstract] [Full Text] [PDF]

				E. Akgul, E.H. Aksungur, K. Korur, K. Aikimbaev, and H. Yaliniz A Rare Complication of Carotid Artery Stenting: Displacement of Marker Ring Causing Locking of Stent and Incomplete Stent Expansion AJNR Am. J. Neuroradiol., August 1, 2007; 28(7): 1403 - 1404. [Abstract] [Full Text] [PDF]

				R. Hofmann, A. Niessner, A. Kypta, C. Steinwender, J. Kammler, K. Kerschner, M. Grund, F. Leisch, and K. Huber Risk Score for Peri-Interventional Complications of Carotid Artery Stenting Stroke, October 1, 2006; 37(10): 2557 - 2561. [Abstract] [Full Text] [PDF]

				R. du Mesnil de Rochemont, S. Schneider, B. Yan, A. Lehr, M. Sitzer, and J. Berkefeld Diffusion-Weighted MR Imaging Lesions after Filter-Protected Stenting of High-Grade Symptomatic Carotid Artery Stenoses AJNR Am. J. Neuroradiol., June 1, 2006; 27(6): 1321 - 1325. [Abstract] [Full Text] [PDF]

				G. Orlandi, S. Gallerini, M. Cosottini, L. Murri, L. K. Sztriha, E. Voros, P. Szikra, and L. Vecsei Postprocedural Emboli in Carotid Artery Stenting: Where Do They Come From? * Response: Stroke, May 1, 2005; 36(5): 928 - 929. [Full Text] [PDF]