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KMID : 0371320110800040283
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Journal of the Korean Surgical Society
2011 Volume.80 No. 4 p.283 ~ p.288
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The early and mid-term results of carotid artery stenting in high-risk patients
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Yun Woo-Sung
Kwun Woo-Hyung
Suh Bo-Yang
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Abstract
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Purpose: This study aimed to investigate early and mid-term outcomes of carotid artery stenting (CAS).
Methods: We retrospectively reviewed 111 patients who were treated for carotid stenosis between October 2004 and December 2009 (42 CASs and 69 carotid endarterectomies [CEAs]).
Results: CAS group was older than CEA group (70 years vs. 67 years, P = 0.001). Coronary artery disease and high lesion above the 2nd cervical vertebral body were more common in CAS group (29% vs. 13%, P = 0.002; 4% vs. 24%, P = 0.004). The 30-days stroke rate was higher in CAS group (10% vs. 1% in CEA group, P = 0.067, Fisher’s exact test). New brain lesions on diffusion-weighted magnetic resonance imaging were more common in CAS group (48% vs. 20% in CEA group, P = 0.002, chi-square test). The 1-, 3-year freedom from stroke were 91%, 84% in CAS group and 99%, 99% in CEA group (P = 0.007, log-rank test). Univariate analysis showed that female gender and age > 70 years were related with postprocedural neurological complications (P = 0.046 and P = 0.007, log-rank test). However, none were independent risk factors on multivariate analysis.
Conclusion: In our series, the rates of peri-procedural neurological complications in CAS group were significantly high. These results suggest that more experience and restricted patient selection will be needed for CAS.
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KEYWORD
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Carotid artery stenosis, Stents, Endarterectomy, Stroke
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