carotid artery stenting a single center “real world” experience颈动脉支架植入一个中心u201c现实世界u201d的经验.pdfVIP

Carotid Artery Stenting: A Single Center ‘‘Real World’’ Experience . . Nazmi Krasniqi , Michael Turgut , Marc Husmann, Marco Roffi, Urs Schwarz, Matthias Greutmann, ¨ Thomas F. Luscher, Beatrice Amann, Roberto Corti* Cardiology, Cardiovascular Center, University Hospital Zurich, Switzerland Abstract Background: Percutaneous carotid artery stenting (CAS) became a widely used procedure in patients with symptomatic and asymptomatic carotid artery stenosis. However its role compared to carotid endarterectomy (CAD) remains questioned. We analysed the safety of carotid artery stenting program of a prospective CAS register program of a tertiary teaching hospital. Method: Between July 2003 and December 2010, 208 patients underwent CAS procedure. Baseline, procedural and follow- up data were prospectively collected. Primary peri-interventional outcome was defined as 30-day major adverse events (MAE), including death, stroke or myocardial infarction, and mid- to long-term follow-up outcome included ipsilateral stroke, myocardial infarction or death. Secondary outcome was restenosis rate $50% per lesion. Results: Unilateral carotid artery interventions were performed in 186 patients. In 22 patients CAS was performed bilaterally as stages procedures. The 30-day MAE rate was 1.9% consisting of two contralateral strokes and two ipsilateral stroke. Mean clinically follow-up was 22 months. Mid- to long-term MAE was 8.1% with 6.3% (n = 13) deaths, 1.9% (n = 4) myocardial infarctions and 0.9% (n = 2) ipsilateral stroke. The restenosis rate $50% per lesion was 4.3% at a mean follow-up of 22 months. Target lesion revascularization was performed in one patient, because of restenosis at 9 months follow-up after first CAS. Conclusion: Implementation of