Received:2005-10-25Correspondenceto:WangYi-ging,Tel:0592-2292207,E-mail:wang_gi-na@163.comSafetyandefficacyofcarotidarterystentingWANGYi-ging1,DavidHoSaiwah2,WANGYan1,ZHENGJian-tao1,JIANGHong-fei1,CHENBing-huang11HeartCenter,ZhongshanHospitalAffiliatedtoXiamenUniversity,TeachingHospitalofFujianMedicalUniversity,Xiamen361004,China;2OueenMaryHospital,HongKong852,ChinaAbstract:ObjectiveToevaluatethesafetyandefficacyofcarotidarterystenting(CAS).MethodsWeprospectivelyevaluat-edthesafetyandefficacyof76carotidarterystenting(CAS)proceduresinaconsecutiveseriesof70Chinesepatients.Thisseriesrepresentedahigh-riskgroupthatincludedpatientswithunstableangina,previousipsilateralCEA,contralateralcarotidarteryocclusion,post-radiationcarotidarterystenosisandothersevereco-morbidconditions.Thepatientshadindependentneurologicalexaminationsbeforeandaftertheprocedureandfollow-upcerebralangiographyat6month.ResultsTheproce-duralsuccessratewas100%.Themeancarotidarterystenosiswas(82!18)%beforeand(5!10)%aftertheprocedure.Duringtheinitialhospitalperiodand30daysafterCAS,therewasnomajorstrokebut3minorstrokes(5.7%).Nomyocardialinfarc-tionsordeathsoccurredduringorwithin30daysfollowingCAS.Atameanfollow-upof20!12months,2patients(2.8%)hadasymptomaticrestenosis,and2non-Owavemyocardialinfarction.Deathoccurredin2cases,butnoneofthemwasat-tributedtoaneurologicalcause.Threepatientshadminorstrokesandnomajorstrokesoccurredduringthefollow-upperiod.ConclusionPercutaneouscarotidarterystentingisfeasibleforperformanceinChinesepatientsandmaylowertherestenosisrate.Keywords:carotidartery;stenting;safetyApproximately600000peoplesufferstrokeeachyearintheUnitedStates,whichleadstonearly160000deathsandleavesmanymorewithmajordisability(AmericanHeartAssociation,1999).Thereissufficientevidenceofthebenefitofrelievinghigh-gradesymp-tomaticandasymptomaticcarotidarteryatheroscleroticobstructionbysurgicalendarterectomy(NorthAmeri-canSymptomaticCarotidEndarterectomyTrialCollab-orator,1991;ExecutiveCommitteefortheAsymp-tomaticCarotidAtherosclerosisStudy,1995;EuropeanCarotidSurgeryTrialists'CollaborativeGroup,1995;NorthAmericanSymptomaticEndarterectomyTrialSteeringCommittee,1991).TheNorthAmericanSymp-tomaticCarotidEndarterectomyTrail(NASCET)demonstratedthesuperiorityofendarterectomyoverdrugtherapyforsymptomaticcarotidstenosis≧70%(NorthAmericanSymptomaticCarotidEndarterectomyTrialCollaborator).TheAsymptomaticCarotidAtherosclero-sisStudy(ACAS)showedastatisticallysignificantre-ductioninstrokeincidenceaftercarotidendarterectomyinasymptomaticcarotidstenosisbyover60%(ExecutiveCommitteefortheAsymptomaticCarotidAtheroscle-rosisStudy,1995).Theselandmarkstudiesprovideconvincingevidenceforthebenefitofrelievingsevereobstructionoftheextracranialcarotidartery.WiththelimitationsofCEAforcertainanatomicalsubgroupsandtheprohibitivelyhighcomplicationsas-sociatedwithcertainsubsetsofpatientswithsignificantcomobidities,thereisaneedforalternativerevascularisationtreatment!1-6".Theadventofpercutaneousendovas-culartechnigueshasthepotentialforsafer,lesstraumat-icandmorecost-effectivemanagementofsymptomaticorasymptomaticcarotidocclusivedisease.Preliminaryreportssuggestthatcarotidangioplastyandstentinghasatherapeuticadvantageinpatientswithcontralateralocclusion,post-CEArestenosisandsurgicallyinaccessi-blelesions!7,8".Endovascularstenttreatmentofcarotidarteryathero...
