The Carotid Artery Stenting Of Extracranial Carotid Artery Stenosis Efficacy Analysis

Objective:To analysis the history characteristics,clinical manifestation,treatment procedure of patients who suffered from the excranial carotid stenosis and received carotid angioplasty and stenting(CAS) in our center retrospectively,the short-term and long-term effect of CAS were evaluated.Methods:From November 2003 to November 2008,clinical data of cases with extracranial carotid stenosis treated with CAS were analyzed retrospectively.The relationship between the clinical feature,lesion,treatment and the outcome were evaluated.Results:There are 114 patients altogether,and 118 carotid arteries were treated.80 of the patients were symptomatic(with 83 carotid arteries) and the rest were asymptomatic,111 of them were arteriosclerosis lesion and 3of them caused by radiation.The range of the stenosis was from 60%to 99%.The symptomatic stenosis were all＞60%,the asymptomatic stenosis were＞70%,except one patient with only 40%stenosis,who received CAS for repeatedly TIA with ulcer plaque. All patients received CAS under EPD in our study.3 kinds of stents were used,the Precise,the Carotid Wallstent and the Mecury.2 TIAs happened during the procedure. The rate of peri-operative neurological complications(all were TIA) was 4.24% (5/118) and the rate of non-neurological complications was 2.54%(3/118).A total of 84 patients(73.68%,84/114) were followed for a mean of 27.7±14.6 months, range from 3months to 5 years.The rate of ipsilateral ischemic stroke was 3.57% (3/84),which caused one death.There was another 1 case of Non-neurological death,so mortality rate is 2.38%(2/84).The rest 78 patients suffered neither TIA nor ischemic stroke.5 patients with stroke sequelae slightly improved their speech and physical function.There was 1 patient with in-stent restenosis.32 cases were followed by X-ray.Stent deformed were found in 4 caese and stent fracture was found in 1 case,who suffered from ischemic stroke 8 months after the procedure.Conclusion:The CAS under EPD causes little trauma,less peri-operative complications.Both of the stroke rate and mortality rate are low.So it is a safe and effective method to treat extracranial carotid stenosis.To get better outcome,it is important to establish strict indication and contraindication base on the clinical features,stenosis degree,artery anatomy and general situation and to choose appropriate stent and EPD as well.