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Refan Alajmi, Riyadh Alokaily
Background: Carotid artery stenting (CASt) is a method of carotid revascularization, which has developed rapidly over the last 3 decades. CASt now used as an alternative to endarterectomise. Although excellent results from centres with high-volume experience seem to demonstrate CASt as technically feasible and safe, there is an on-going debate about the complications in terms of early outcomes in patients.
Methods: This study was a retrospective study on patients diagnosed with carotid artery stenosis (CASs). The data collected from Jan 2011 to Dec 2019. The patient data screened for inclusion in the study based on findings from contrast angiography. Primary complications to be assessed were major or minor embolic stroke, cardiac arrest, and death within 30 days of the procedure. Minor stroke, myocardial infarction, acute hypotension and bradycardia, no cerebral bleeding, access-site bleeding was considered secondary outcomes.
Results: A total of 77 patients were included in the study with a mean age of 74.4 ± 11.3 years. The technical procedure of CASt was 100% successful for all the patients. Overall post-procedural stroke rate at 30 days was 7.7% (six out of 77). One (1.3%) patient died due to cardiac arrest. There were two cases (2.6%) of acute hypotension and Bradycardiac and one case (1.3%) of Access-site bleeding within 30 days of stent implantation. Comorbid conditions were not significantly (p>0.05) associated with the post- procedural complications in CASt.
Conclusion: In this study, we found that CASt is the most reliable technique for CASs and appears feasible and comparatively safe with least post-procedural complications.
However, advanced techniques are required to further reduce the death/stroke rate within 30 days of stent implantation.