LOW INCIDENCE OF SYMPTOMATIC STROKES AFTER CAROTID STENTING WITHOUT EMBOLIZATION PROTECTION DEVICES FOR EXTRACRANIAL CAROTID STENOSIS : A SINGLE-INSTITUTION RETROSPECTIVE REVIEW. Commentary

摘要: OBJECTIVE: Carotid angioplasty and stenting (CAS) remains the primary modality of treating individuals with carotid stenosis significant comorbidities or anatomically difficult lesions. The use embolization protection devices (EPD) has been mandated by cerebrovascular community even though ability these to prevent symptomatic strokes is not supported current literature. Our goal was assess clinical radiological outcomes patients who underwent CAS without EPDs at our hospital from 1996 2006. METHODS: We performed a retrospective chart analysis all Jefferson Hospital for Neuroscience in Philadelphia, PA. angiographic were studied retrospectively using reviews operative, angiographic, reports. mean follow-up period 18.6 months. RESULTS: One hundred five (97.2%) had 1 month. During this period, following complications observed: accidents 2 (1.9%), myocardial infarctions femoral hematoma patient (0.9%), retroperitoneal hematomas 3 (2.8%), cervical dissections 4 (3.7%); (1.9%) died. Seventy-six (80.9%) (2.6%) accidents, which fatal. long-term morbidity mortality rate 2.6%. In same restenosis (>50% baseline) 9.2% (7 patients). Three (3.9%) went on require repeat CAS. CONCLUSION: experience reveals that can be safely risks similar those reported series used. Any procedure device adds risk cost should evaluated randomized, controlled trial evaluate its efficacy, especially situations published data provide conflicting results. no exception paradigm.