Complications after carotid artery stenting in patients with carotid artery stenosis / 中华普通外科杂志

ABSTRACT

Objective To analyze complications of carotid artery stenting (CAS) and preventions.Methods Clinical data and treatment outcomes of 72 consecutive patients ( 80 stents ) from July 2006 to January 2012 with carotid stenosis were analyzed.Asprin 100 mg and clopedigrel 75 mg were given orally 5 days before CAS.Distal embolic protection device were implanted in all patients,pre-dilatation was done for those with carotid stenosis ＞ 90％ and post-dilatation was done for those of residual stenesis ＞ 30％.Severe complications of CAS mean death,myocardial infarction (MI) and stroke.Other minom included transient ischemic attack ( TIA ),hyperperfusion and intracranial hemorrhage ( ICH ),bradycardia and/or hypotension,hypertension,access hematoma or bleeding.Results In 72 patients a total of 80 self-expandable bare stents were successfully implanted.Distal embolic protection devices were used in all cases.Combined procedure was taken in 5 cases including OPCABG in 2 cases,left subclavain artery stenting in 2 cases and renal artery stenting in 1 case.The overall in-hospital complications was 37.5％ (27 of 72).Of these events,1 case had minor strokes defined as a modified Rankin Scale score less than 3 at 1-year follow-up,2 patients (2.78％ ) experienced a hemispheric TIA (neurological symptoms that resolved within 24 hours),1 patient experienced hyperperfusion syndrome.The overall mortality rate was 0,21 cases (29.2％ ) experienced hemodynamic instability (hypotension in 15 cases,bradycardia in 5 cases and hypertension in 1 case) and 2 others had access hematoms.The 30-day death/stroke/myocardial infarction risk was 1.39％ (1 minor stroke).Conclusions Hemedynamic instability (hypotension and bredycardia) is main complications of carotid artery stenting in patients with carotid artery stenosis,severe complications are rare.