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European registry of carotid artery stenting: Results from a prospective registry of eight high volume EUROPEAN institutions
Author(s) -
Stabile Eugenio,
Garg Pallav,
Cremonesi Alberto,
Bosiers Marc,
Reimers Bernhard,
Setacci Carlo,
Cao Piergiorgio,
Schmidt Andrej,
Sievert Horst,
Peeters Patrick,
Nikas Dimitry,
Werner Martin,
de Donato Gianmarco,
Parlani Giambattista,
Castriota Fausto,
Hornung Marius,
Mauri Laura,
Rubino Paolo
Publication year - 2012
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.24348
Subject(s) - medicine , carotid endarterectomy , stroke (engine) , revascularization , incidence (geometry) , carotid artery disease , clinical trial , endarterectomy , carotid stenting , prospective cohort study , carotid arteries , surgery , myocardial infarction , mechanical engineering , physics , optics , engineering
Background Carotid endarterectomy (CEA) is the standard revascularization therapy to prevent stroke in patients with carotid artery disease. Carotid artery stenting (CAS) could be considered a potential alternative in patients at high surgical risk. Recent clinical trials have challenged this concept due a relatively high incidence of post‐CAS adverse events, which occurred in low volume centers. The aim of this study was to evaluate the outcomes associated with neuroprotected CAS in selected high volume centers. Methods From January 2007 to December 2007, 1,611 patients underwent neuroprotected CAS in eight European Centers. For each patients, clinical, procedural, and one month follow‐up data from all patients have been collected. An independent clinical events committee adjudicated the events. Results Overall in hospital death was 0.06% (one patient), whereas in‐hospital stroke was 0.49% (eight patients). Between hospital discharge and 30 days three additional patients died (0.18%) and 10 patients experienced a stroke (0.67%). Overall 30 days mortality was 0.24% (four patients) and stroke incidence 1.12% (18 patients). The 30 day stroke/death rate was 1.36%. Conclusions CAS is a reasonable alternative to CEA to treat carotid artery atherosclerosis in well‐experienced high volume centers. These data suggest that future prospective trials comparing CAS and CEA outcomes should include only centers highly experienced in both treatment modalities. © 2012 Wiley Periodicals, Inc.