ANGIOPLASTY AND STENTING OF THE EXTRACRANIAL CAROTID ARTERIES (PART III)

M. Henry, M. Amor, I. Henry, I. Masson, K. Tzvetanov
Polyclinique,
Essey-les-Nancy, France

DISCUSSION Carotid endarterectomy is still the reference treatment for carotid stenosis. Yet, it has its own inherent risks and limitations. Based on the results from various national and international trials, the Ad Hoc Committee of the American Heart Association has proposed the following guidelines to perform carotid endarterectomy. In asymptomatic patients with stenosis >60%: Risks for stroke and/or death <3%; Long term risks of stroke <2% per year. In symptomatic patients with stenosis >70%: Risks for stroke and/or death <6%; Long term risks of stroke <3% per year. In patients with recurrent stenosis: perioperative risks <10%. In order to consider carotid angioplasty as an alternative to surgery, its complication rate should be similar to that of endarterectomy. Our study, like several other recently published studies, has shown that carotid angioplasty with stent placement may be performed with a complication rate that is not higher than that of surgery despite the large number of high risk patients included in these studies. The major neurological complication rate in our series was 1.5%, and the minor neurological complication rate was 3.5%.

KEY WORDS: сarotid stenting.

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