Abstract

Carotid artery stenting (CAS) was approved in Japan in October 2007. Since then, several embolic protection devices (EPD) and stents for CAS have become available.

We investigated the clinical treatment results and periprocedural ischemic complications of CAS by using a standard procedure.

We retrospectively analyzed 312 patients with 329 carotid artery stenoses (272 men; age 39–97 years [mean 73.7 years]; symptomatic stenosis, 144 lesions; mean stenosis rate, 82.1%) who underwent CAS from October 2007 to March 2014. The technical success rate, periprocedural ipsilateral ischemic stroke, and incidence of ischemic lesions within 48 h after CAS with EPD were assessed using diffusion weighted images (DWIs).

All cases of CAS were successful. Among nine patients (2.7%) who suffered a stroke, a major stroke occurred in one patient (0.3%) and minor strokes in eight patients (2.4%). The EPDs and stents used were as follows: Angioguard XP/RX(AG), 141; Filterwire EZ (FW), 128; MoMa Ultra (MU), 52; Spider FX, 2; Percusurge, 2; Precise (PS), 215; Carotid Wallstent (CWS), 97; Protégé (PT),14; PS and CWS, 2; PS and PT, 1. Over 50 cases of stroke and new ischemic lesions by EPD were observed in AG, 2.8% (4/141) and 33.1% (46/139); FW, 2.3% (3/128) and 22.0% (28/127); and MU, 3.8% (2/52) and 41.1% (21/51), respectively.

The CAS by the standard procedure showed very good clinical treatment results. The incidence of ischemic lesions on DWI was much lower in FW than in the other EPDs.