39 巻 (2011) 5 号 p. 329-333
Between January 2004 and December 2009, we performed carotid artery stenting (CAS) for 220 sides. Among them, we evaluated 142 sides of 136 cases at follow-up ＞1 year, and studied the long-term occurrence of recurrent stenosis (＞50% by ultrasound or angiography), ipsilateral ischemic stroke, unstable angina pectoris (u-AP) or acute myocardial infarction (AMI), and death.
Over a median follow-up period of 36.6 months, the incidence of recurrent stenosis was 8.5% (12 sides), with only 1 side leading to neurological symptoms. Among them, 6 sides of recurrent stenosis occurred in the first 12 months after CAS. This suggests recurrent stenosis is caused by intima hyperplasia rather than by progressive atherosclerosis. Ipsilateral ischemic strokes occurred in 2.8% (4 sides), but only 1 side derived from carotid stenosis after stenting. U-AP and AMI occurred in 4.2% (6 cases) after CAS. Twelve cases resulted in death, though no death was caused by carotid stenosis or ischemic stroke.
Stenting for carotid stenosis is an effective treatment to prevent stroke over long terms. Recurrent stenosis after CAS occurs more frequently than previous reports indicate. We should be aware of coronary disease events.