ANGIOPLASTY AND STENTING OF CAROTID ARTERY STENOSIS WITH EMBOLIC PROTECTION DEVICES

Carotid artery stenting (CAS) has recently been recommended as an alternative to carotid endarterectomy (CEA) by some clinicians. This study was designed to evaluate the success rate and in-hospital and 30-day adverse events in our first experiences in Iran for CAS with protection devices, to document our results and guide further use of CAS. From December 2003 to December 2004 we performed 21 consecutive CAS procedures. 16 were men and 5 were women with mean age of 62 years (range 46-78 years). Indications for CAS included primary lesions in all patients with stenosis >50% in symptomatic and stenosis >80% in asymptomatic patients. CAS was technically successful in a1l 21 patients. Mean severity of stenosis before CAS was 85%+14% compared with 15%+10% after CAS. No periprocedural death occurred. No in-hospital and 30-days minor or major stroke/ death was seen. Our data suggest that percutaneous stenting of the carotid artery when a cerebral protection device is used is feasible and effective but not without technical difficulties and potential complications. We recommended CAS for high-risk patients for carotid endarterectomy, but this technique has a learning curve for those willing to perform the procedure with a low rate of complications.