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Percutaneous stenting of the internal carotid artery: the European CAST I Study. Carotid Artery Stent Trial

To report the results of a multicenter safety trial of percutaneous carotid stenting performed by vascular surgeons. Symptomatic or asymptomatic patients > or = 65 years of age with internal carotid artery (ICA) stenoses > or = 70% and < or = 2-cm long were eligible for enrollment. The proc...

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Published in:Journal of endovascular surgery 1999-05, Vol.6 (2), p.155-159
Main Authors: Bergeron, P, Becquemin, J P, Jausseran, J M, Biasi, G, Cardon, J M, Castellani, L, Martinez, R, Fiorani, P, Kniemeyer, P
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container_issue 2
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container_title Journal of endovascular surgery
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creator Bergeron, P
Becquemin, J P
Jausseran, J M
Biasi, G
Cardon, J M
Castellani, L
Martinez, R
Fiorani, P
Kniemeyer, P
description To report the results of a multicenter safety trial of percutaneous carotid stenting performed by vascular surgeons. Symptomatic or asymptomatic patients > or = 65 years of age with internal carotid artery (ICA) stenoses > or = 70% and < or = 2-cm long were eligible for enrollment. The procedures were performed in an operating room with the choice of anesthesia and the percutaneous access site at the discretion of the surgeon. Only Palmaz stents were used. From January 1, 1996 to December 31, 1997, 99 patients (74 men, mean age 70 years, range 51 to 94) were enrolled in the study. More than half (57 of 99 patients) were asymptomatic. The direct cervical approach was used predominantly (97%). Three (3%) cases were converted to surgery for inability to access the artery or deploy the stent (technical success 97%). No perioperative death or myocardial infarction was reported. Six (6%) procedural complications included 1 reversible arterial spasm, 2 dissections, 1 cervical hematoma, and 2 residual stenoses. One neurological event reversed within 7 days (1% minor stroke rate) and 4 (4%) transient ischemic attacks resolved within 24 hours. One (1%) asymptomatic early occlusion occurred 2 days postoperatively. No neurological event was observed in the 1- to 24-month follow-up (mean 13 months). Two (2%) patients died of nonprocedurally related causes. No stent compression was seen, but 1 asymptomatic occlusion and 3 asymptomatic, non-flow-limiting restenoses (2 < 40%, 1 at 60%) were found within 1 year (3% restenosis rate on an intention-to-treat basis). Patency was 98% at 1 year. The results of this trial support the contention that carotid stenting of short ICA lesions can be performed with a low neurological complication rate.
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identifier ISSN: 1074-6218
ispartof Journal of endovascular surgery, 1999-05, Vol.6 (2), p.155-159
issn 1074-6218
language eng
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source SAGE
subjects Aged
Aged, 80 and over
Angiography
Blood Vessel Prosthesis Implantation - methods
Carotid Artery, Internal - diagnostic imaging
Carotid Artery, Internal - surgery
Carotid Stenosis - diagnostic imaging
Carotid Stenosis - physiopathology
Carotid Stenosis - surgery
Europe
Female
Follow-Up Studies
Humans
Male
Middle Aged
Postoperative Complications
Recurrence
Retrospective Studies
Safety
Stents
Tomography, X-Ray Computed
Treatment Outcome
Ultrasonography, Doppler, Duplex
title Percutaneous stenting of the internal carotid artery: the European CAST I Study. Carotid Artery Stent Trial
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