Carotid artery stenting - agony and ecstasy

Abstract

Aim and background. Carotid artery stenting (CAS) is already well known and accepted as an alternative treatment of carotid artery disease. Various complications of the procedure have been reported in literature. We report in this article the incidence and management of the complications occurred during or after the procedure.

Methods. From January 2004-December 2008, a total of 121 consecutive patients underwent percutaneous angioplasty and stenting of the extracranial carotid artery. A total of 134 procedures were performed. The endovascular procedure was conducted under embolic protection devices.

Results. The percutaneous procedure was successful in all the patients (100%). No periprocedural death occurred with any embolic protection device. The overall major complication rate was 2.23%. Major adverse events included 2 major strokes (1.49%) and 1 case (0.74%) of accute stent thrombosis.

The minor complications were 14 (10.44%): minor stroke - 2 cases (1.49%), carotid artery spasm - 7 cases (5.22% - cerebral protection device-related compli-cations), hyperperfusion syndrome - 5 patients (3,73%).

Conclusions. Our data suggest that percutaneous stenting of the carotid artery when a cerebral protection device is used is feasible and effective but not without potential complications. However, a long learning curve of the stenting procedure and embolic protection devices insertion may lower the incidence of major and minor complication.