Carotid artery stenting alone or without post-stenting angioplasty: sequential change of luminal diameter following carotid artery stenting

Abstract

Objectives: We prospectively assessed feasibility and efficacy of carotid artery stenting (CAS) alone or without post-dilatation in patients with severe symptomatic carotid stenosis.
Methods: During a 12 month period, we treated 9 men (mean age 68.1 years) considered to be at high-risk for carotid endarterectomy with symptomatic severe carotid artery stenosis, Carotid echo demonstrated soft plaques in 6 and calcification in 2 patients. We used distal protection throughout the procedures. Of the 9 patients, pre-dilatation with low-pressure using a small sized balloon catheter was performed in 6 patients due to a small caliber of stenotic portion less than 2mm. The other 3 patients were treated by stenting alone.
Results: Preoperative mean stenosis of 83.6% decreased to 20.3% after one month, and to 11.3% after 12 months following CAS. Procedure-related hypotension with or without bradycardia was observed in 7 patients. One patient developed new ischemic neurological symptoms due to distal embolism 31 hours after the procedure.
Conclusions: Our results suggest that sufficient luminal dilatation after CAS alone or without post-dilatation can be obtained due to serial expansion of the stent during the follow-up periods. Additional studies are necessary to clarify the effect of CAS alone or without post-dilatation on reduction of periprocedural ischemic complications.