Internal carotid artery stenting for secondary prevention of stroke: case series study

Abstract

Background: Internal carotid artery atherosclerosis accounts for an estimate of 15 – 25% of ischemic strokes. Carotid revascularization techniques have proven useful in reducing the incidence of ischemic stroke. Nowadays, carotid artery stenting is a basic treatment for carotid stenosis. Material and methods: The study represents a series of 60 consecutive symptomatic patients who underwent carotid stenting for critical carotid stenosis between August 2019 and April 2021. All the procedures were performed in Institute of Neurology and Neurosurgery. Main outcomes like morbidity and mortality rates at 30 days post procedure; repeated ischemic stroke in the territory of stented artery; and common complications were registered. Results: All the patients were initially evaluated with an angiographic study (CT angio or angiography) for planning the intervention. The patients were operated under conscious sedation and with distal embolic protection. The design of the stents was chosen according to the vascular anatomy of carotid bifurcation. In our case series of patients, we did not register major complications during, or in first 30 days after the procedure. One patient had a hyperperfusion syndrome, which was resolved with careful arterial tension monitoring. Conclusions: Carotid stenting is a safe and efficient procedure, with low periprocedural complications and good outcomes in correctly selected patients. Due to its minimal invasiveness, in the future it may become first choice procedure in the treatment of carotid artery stenosis.