Long-term results of carotid stenting are competitive with surgery

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Presentation transcript:

Long-term results of carotid stenting are competitive with surgery Patrice Bergeron, MD, Michel Roux, MD, Patrick Khanoyan, MD, Valérie Douillez, MD, Jacques Bras, MS, Joël Gay, MS Journal of Vascular Surgery Volume 41, Issue 2, Pages 213-221 (February 2005) DOI: 10.1016/j.jvs.2004.11.037 Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 1 In this patient, the tortuousities of the (A) left common carotid artery and (B) internal carotid artery did not allow the placement of the filter device. C, The stenting procedure was successfully achieved with a Parodi Anti-Emboli System protective device (ArteriA). Journal of Vascular Surgery 2005 41, 213-221DOI: (10.1016/j.jvs.2004.11.037) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 2 Life-table analysis showing a freedom from new neurologic events, all strokes, and fatal strokes of 90%, 96%, and 98%, respectively, at 10 years. Journal of Vascular Surgery 2005 41, 213-221DOI: (10.1016/j.jvs.2004.11.037) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 3 Life-table analysis of all ipsilateral neurologic complications after carotid artery stenting. The freedom at 10 years from new ipsilateral neurologic events is 92%, whereas the ipsilateral stroke freedom is 98%. Journal of Vascular Surgery 2005 41, 213-221DOI: (10.1016/j.jvs.2004.11.037) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 4 Left, Fresh and (right) repaired sample of the ulceration (arrowhead) that developed just below the stent (arrows). The patient, who was symptomatic, was operated on and the carotid body was excised. The stent appears with no in-stent restenosis, contrary to what was expected. Journal of Vascular Surgery 2005 41, 213-221DOI: (10.1016/j.jvs.2004.11.037) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 5 Left, dilation of a compressed balloon-expandable stent under intravascular ultrasound guidance. Right, the localization and morphology of the stent is achieved through three-dimensional reconstruction of a computed tomography scan. Journal of Vascular Surgery 2005 41, 213-221DOI: (10.1016/j.jvs.2004.11.037) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 6 Patency rates observed during 10 years. Life-table analysis shows a primary patency rate of 88% at 10 years, whereas the primary assisted patency rate is 95%. Journal of Vascular Surgery 2005 41, 213-221DOI: (10.1016/j.jvs.2004.11.037) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions