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Patient Selection Criteria and Procedural Standardization for Carotid Artery Stenting—A Single Center Experience

The gold standard for the treatment of carotid artery stenosis is the carotid endarterectomy (CEA). According to current guidelines, carotid artery stenting (CAS) is an alternative. Randomized control trials (RCTs) show significantly higher rates of peri-interventional strokes after CAS compared to...

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Detalles Bibliográficos
Autores principales: Calo, Paolo, Oberhuber, Alexander, Görtz, Hartmut
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219064/
https://www.ncbi.nlm.nih.gov/pubmed/37240640
http://dx.doi.org/10.3390/jcm12103534
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author Calo, Paolo
Oberhuber, Alexander
Görtz, Hartmut
author_facet Calo, Paolo
Oberhuber, Alexander
Görtz, Hartmut
author_sort Calo, Paolo
collection PubMed
description The gold standard for the treatment of carotid artery stenosis is the carotid endarterectomy (CEA). According to current guidelines, carotid artery stenting (CAS) is an alternative. Randomized control trials (RCTs) show significantly higher rates of peri-interventional strokes after CAS compared to CEA. However, these trials were usually characterized by a great heterogeneity in the CAS procedure. In this retrospective analysis from 2012 to 2020, 202 symptomatic and asymptomatic patients were treated with CAS. Patients were carefully pre-selected according to anatomical and clinical criteria. In all cases, the same steps and material were used. All interventions were performed by five experienced vascular surgeons. Primary endpoints of this study were perioperative death and stroke. Asymptomatic carotid stenosis was present in 77% of the patients and symptomatic in 23%. The mean age was 66 years. The average degree of stenosis was 81%. The CAS technical success rate was 100%. Periprocedural complications occurred in 1.5% of cases, including one major stroke (0.5%) and two minor strokes (1%). The results of this study indicate that through a strict patient selection based on anatomical and clinical criteria, CAS can be performed with very low complication rates. Furthermore, standardization of the materials and the procedure itself is crucial.
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spelling pubmed-102190642023-05-27 Patient Selection Criteria and Procedural Standardization for Carotid Artery Stenting—A Single Center Experience Calo, Paolo Oberhuber, Alexander Görtz, Hartmut J Clin Med Article The gold standard for the treatment of carotid artery stenosis is the carotid endarterectomy (CEA). According to current guidelines, carotid artery stenting (CAS) is an alternative. Randomized control trials (RCTs) show significantly higher rates of peri-interventional strokes after CAS compared to CEA. However, these trials were usually characterized by a great heterogeneity in the CAS procedure. In this retrospective analysis from 2012 to 2020, 202 symptomatic and asymptomatic patients were treated with CAS. Patients were carefully pre-selected according to anatomical and clinical criteria. In all cases, the same steps and material were used. All interventions were performed by five experienced vascular surgeons. Primary endpoints of this study were perioperative death and stroke. Asymptomatic carotid stenosis was present in 77% of the patients and symptomatic in 23%. The mean age was 66 years. The average degree of stenosis was 81%. The CAS technical success rate was 100%. Periprocedural complications occurred in 1.5% of cases, including one major stroke (0.5%) and two minor strokes (1%). The results of this study indicate that through a strict patient selection based on anatomical and clinical criteria, CAS can be performed with very low complication rates. Furthermore, standardization of the materials and the procedure itself is crucial. MDPI 2023-05-18 /pmc/articles/PMC10219064/ /pubmed/37240640 http://dx.doi.org/10.3390/jcm12103534 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Calo, Paolo
Oberhuber, Alexander
Görtz, Hartmut
Patient Selection Criteria and Procedural Standardization for Carotid Artery Stenting—A Single Center Experience
title Patient Selection Criteria and Procedural Standardization for Carotid Artery Stenting—A Single Center Experience
title_full Patient Selection Criteria and Procedural Standardization for Carotid Artery Stenting—A Single Center Experience
title_fullStr Patient Selection Criteria and Procedural Standardization for Carotid Artery Stenting—A Single Center Experience
title_full_unstemmed Patient Selection Criteria and Procedural Standardization for Carotid Artery Stenting—A Single Center Experience
title_short Patient Selection Criteria and Procedural Standardization for Carotid Artery Stenting—A Single Center Experience
title_sort patient selection criteria and procedural standardization for carotid artery stenting—a single center experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219064/
https://www.ncbi.nlm.nih.gov/pubmed/37240640
http://dx.doi.org/10.3390/jcm12103534
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