Evolving Indications for and Early Results of Carotid Artery Stenting

: While carotid endarterectomy continues to be the gold standard of treatment for most patients with significant carotid artery disease, there are cases where lesion or anatomy-related factors create situations less than ideal for conventional surgery. Other therapeutic modalities, such as endoluminal stenting, may represent reasonable options for such patients. : Thirty-three patients with 70% or greater internal carotid artery lesions were treated by endovascular stent placement from July 1994 through June 1996. Indications included transient ischemic attacks in 20 and previous stroke in 4; and 9 were asymptomatic. : Stents were placed successfully in all instances. Mortality and stroke rates were zero. All patients remained asymptomatic during follow-up (mean 8 months), and stent patency by duplex ultrasound has been 100%. A single instance of intrastent restenosis has been observed. : Endoluminal stenting is an investigational technique of unproven efficacy and long-term durability. Yet it appears technically feasible, and possibly reasonable, as an alternate option for cases unfavorable for standard surgery.