Safety and Efficacy of Carotid Angioplasty/Stenting in 100 Consecutive High Surgical Risk Patients: Immediate and Long-Term Follow-up

Background/purpose. This study analyzes the safety and efficacy of carotid angioplasty/stenting (CAS) with embolic protection devices in high surgical risk (HSR) patients. Patient population/methods. This study includes 100 consecutive HSR patients, who were followed prospectively, and had carotid duplex ultrasounds at 1 month and every 6 months thereafter. A Kaplan—Meier lifetable analysis was used to estimate survival rates, rates of freedom from stroke, and freedom from ≥50% in-stent restenosis. Results. Mean age was 69.6 years. There were 59 men and 41 women. Mean follow-up was 26.1 months (range, 1-50). Indications for CAS were symptomatic ≥50% stenosis in 47% and ≥80% asymptomatic stenosis in 53%. Procedure success rate was 100%. HSR includes 33% with restenosis and cardiac comorbidity, 21% with restenosis and cardiac/medical comorbidities, 13% with restenosis only, and 33% with cardiac/medical comorbidities. The 30-day perioperative stroke rate was 2% with no perioperative deaths or MI. Stroke-free...