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Background Though carotid artery stenting (CS) has gained popularity as an alternative to carotid endarterectomy, studies examining long‐term results are limited. Methods All consecutive patients who underwent unilateral CS between 7/1993 and 8/2005 with no or non‐significant contralateral stenosis were included. Follow‐up with duplex sonography and/or angiography and neurological assessment was performed at 6 and/or 12 months. Thereafter, annually, a questionnaire was sent to the patients and their referring physicians. Results Two‐hundred and seventy‐nine patients underwent CS. In 99% of procedures stent delivery was successful. The periprocedural major and minor stroke rates were 2.2%, respectively. The periprocedural major stroke or death rate was 2.9%. Median clinical follow‐up was 49 ± 32 months (range: 30 days–12.1 years). Excluding perioperative (<30 days) events, the annual major and minor stroke rate was 1.3% and the annual ipsilateral major and minor stroke rate was 0.6%. In symptomatic and asymptomatic patients, the annual major and minor stroke rates were 2.2% and 0.8%, respectively, and the ipsilateral major and minor stroke rates were 1.1% and 0.3%, respectively. There was no significant difference between ipsilateral and contralateral major or minor strokes at long‐term follow‐up. At last sonographic follow‐up (median 36 ± 32 months), restenosis rates for symptomatic and asymptomatic stenoses were 5% and 3%, respectively. Conclusion The results of our study demonstrate very low long‐term cerebral event rates after CS supporting the long‐term safety of CS. Importantly, there was no significant difference in long‐term ipsilateral versus contralateral cerebral events lending support to the hypothesis of plaque stabilization.
Journal of Interventional Cardiology – Wiley
Published: Dec 1, 2013
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