Carotid artery stenting for symptomatic carotid artery stenosis: A single centre experience of 150 cases

Abstract

Objective: Carotid artery stenting is presently universally adopted for treatment of carotid artery stenosis. The objective of this study was to analyze the outcomes of carotid artery stenting (CAS) performed in a single institution.

Materials and Method: We retrospectively studied on 150 cases, who presented in our Hospital from January 2015 to January 2024. All patients were symptomatic including 66 cases performed with distal embolic protection device (DEPD) and 84 cases without distal embolic protection device. Procedure –related morbidity and mortality as well as influencing factors for outcomes were assessed. Modified Rankin scale (mRS) score was applied to evaluate outcome. Mean, median and t/Chi-square test were used to analyze data.

Results: There were 99 males and 51 females with mean age of 64.2 (ranged 20-81) years. The maximum incidence was noted in age group of 50-70 years (62%) with more case with symptoms of transient ischemic attack (TIA) (65.3%). Hyperlipidemia was significantly higher in DEPD group compared to non-DEPD group (p=0.03). Ulcerated plaque was significantly higher in DEPD group compared to non-DEPD (p<0.0001). Co-morbidities (HTN, DM, hyperlipidemia, smoker, and previous stroke history), age as well as pre/post stenting degrees of stenosis were significantly correlated with outcomes. 0ne case with distal embolic stroke was noted in non-DEPD group, but no mortality and re-stenosis were reported at mean follow up period of 11.2±6.7 Months.

Conclusions: Carotid artery stenting for sever stenosis is found to be safe and successful strategy. However, appropriate precaution should be reimbursed to the patients who have ulcerated plaque.