Carotid Stenting Done Exclusively by Vascular Surgeons

Abstract

The authors report 30-day and mid-term outcomes of carotid artery angioplasty and stenting (CAS) performed by vascular surgeons in 175 cervical carotid stenoses. Procedures were performed with local anesthesia by percutaneous femoral access. Intraoperative complications included 2 seizures and 4 asystolic arrests, which were managed medically without sequelae. During the 30-day follow-up, there were no deaths or myocardial infarctions. A major or minor stroke occurred in 2 patients each; 3 patients had transient ischemic attacks, and 1 patient had a major access-site complication. At late follow-up, 3 patients had restenosis, all of which were treated with repeat angioplasty. At the 6-month follow-up, one asymptomatic occlusion was detected. There were no late carotid-related deaths or complications. The authors concluded that vascular surgeons who possess advanced catheter-based skills can safely perform CAS with results comparable to carotid endarterectomy.