Carotid Angioplasty and Stenting for Atherosclerotic Stenosis: Case Series

Abstract
Background: Carotid artery stenting is an alternative to endarterectomy in treatment of carotid artery stenosis. Com-parative studies have shown different results regarding the outcome of both techniques.
Aim of Study: The aim of our study is to present our experience in carotid artery stenting and compare our results with the literature.
Patients and Methods: A retrospective analysis of our series of patients who underwent carotid artery angioplasty/ stenting, between January 2011 and April 2018, in Kasr Al-Ainy University Hospital and Sheikh Zayed Specialized Hospital was performed. Peri-procedural and delayed, minor and major complications rates as well as the rate of restenosis over the follow-up period were analyzed.
Results: A total of 106 patients who underwent 109 procedures of carotid artery angioplasty/stenting were included for analysis. Average age of patients was 63±7 years, with 71 male (67%). Symptomatic stenosis was seen in 81 cases (74.3%) and asymptomatic stenosis was seen in 28 cases (25.7%). Filter protection device was used in 69 cases (63.3%) and 40 cases (36.7%) were done without protective device. Pre-stent dilatation was performed in 21 cases (19.2%). Post-stent dilatation was performed in 75 cases (68.8%). Both pre and post-stent dilatations were done in 9 cases (8.2%). No balloon dilatation was done in 3 cases (2.7%). In one case (0.9%) angioplasty was done without stenting. Minor compli-cations occurred in 4 cases (3.7%) in the form of 3 cases of intra-procedural and 1 case of post-procedural transient ischemic attack. Two major complications (1.8%) occurred in the form of distal showering with middle cerebral artery occlusion in 1 case, and retroperitoneal hematoma in another case. Two cases (1.8%) of intraprocedural adverse events occurred in the form of dissection without clinical sequelae. Two cases of insignificant restenosis were encountered in the follow-up.
Conclusion: Carotid artery stenting is an effective and relatively safe alternative to carotid endarterectomy. Further studies assessing the value of embolic protective devices and the best type of stent should be conducted.