ANGIOPLASTY AND STENTING OF CAROTID ARTERY STENOSIS WITH EMBOLIC PROTECTION DEVICES

Background: Carotid artery stenting (CAS) has recently been recommended as an alternative to carotid endarterectomy (CEA) by some clinicians. Objective: 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. Methods: 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. Results: 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. Conclusion: 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.