An experience with angioplasty and stenting of carotid artery stenosis with embolic protection devices.

BACKGROUND Carotid artery stenting has recently been recommended as an alternative to carotid endarterectomy by some clinicians. OBJECTIVE To evaluate success rate, as well as in-hospital and 30-day adverse events in our first experience in Iran for carotid artery stenting with protection devices. METHODS From December 2003 through July 2004, we performed 12 consecutive (9 males and 3 females) carotid artery stenting procedures. The patients had a mean age of 62 (range: 46 - 78) years. Indications for carotid artery stenting included primary lesions in all patients, stenosis > or =50% in symptomatic, and stenosis > or =80% in asymptomatic patients. RESULTS Carotid artery stenting was technically successful in all 12 patients. The mean +/- SD severity of stenosis before carotid artery stenting was 85 +/- 14% as compared with 15 +/- 10% after the procedure. No periprocedural death occurred. No in-hospital or 30-day minor or major stroke/death was observed. CONCLUSION Percutaneous stenting of the carotid artery stenosis, when a cerebral protection device is used, is feasible and effective but not without technical difficulties and potential complications. We, therefore, recommend carotid artery stenting for patients who are at high risk for undergoing carotid endarterectomy. Nevertheless, a long-learning curve may be needed for anyone who wishes to start this technique.