Elective Carotid Artery Stenting in the Presence of Contralateral Occlusion

Am J Cardiol. 1998 Jun 1;81(11):1315-7. doi: 10.1016/s0002-9149(98)00161-1.

Abstract

Significant carotid stenosis in the presence of an occluded contralateral artery has a poor prognosis with medical therapy alone. Carotid cross clamping during surgical endarterectomy results in critical flow reductions in patients with inadequate collateral flow, and represents a significant risk for procedural strokes. Carotid stenting is being evaluated as an alternative to endarterectomy. We describe the immediate and late outcome of a series of 26 patients treated with carotid stenting in the presence of contralateral carotid occlusion. The mean age of the patients in this group was 65 +/- 9 years, 23 (89%) were men and 10 (39%) were symptomatic from the vessel treated. The procedural success of carotid stenting in this group of patients was 96%. The mean diameter stenosis was reduced from 76 +/- 15% to 2.8 +/- 5%. There was 1 (3.8%) minor stroke in a patient who developed air embolism during baseline angiography. At late follow-up there was no neurologic event in any patient at a mean of 16 +/- 9.5 months after the procedure. Thus, carotid stenting of lesions with contralateral occlusion can be performed successfully with a low incidence of procedural neurologic complications and late stroke.

MeSH terms

  • Aged
  • Brain Ischemia / diagnosis
  • Brain Ischemia / therapy*
  • Carotid Stenosis / diagnosis
  • Carotid Stenosis / therapy*
  • Cerebrovascular Disorders / etiology
  • Diagnostic Imaging
  • Female
  • Follow-Up Studies
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Middle Aged
  • Neurologic Examination
  • Risk Factors
  • Stents*
  • Treatment Outcome