American Journal of Cardiology
Volume 81, Issue 11 , Pages 1315-1317, 1 June 1998

Elective Carotid Artery Stenting in the Presence of Contralateral Occlusion

  • Atul Mathur, MD, DM

      Affiliations

    • Department of Medicine, Division of Cardiovascular Disease, The University of Alabama at Birmingham, Birmingham, Alabama, USA
    • ,
  • Gary S. Roubin, MD, PhD

      Affiliations

    • Department of Medicine, Division of Cardiovascular Disease, The University of Alabama at Birmingham, Birmingham, Alabama, USA
    • Corresponding Author InformationAddress for reprints: Gary S. Roubin, MD, PhD, Division of Cardiovascular Diseases, Lennox Hill Hospital, Black Hall, 130 East 77th Street, New York, New York 10021-1803
    • ,
  • Camilo R. Gomez, MD

      Affiliations

    • Department of Medicine, Division of Neurology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
    • ,
  • Sriram S. Iyer, MD

      Affiliations

    • Department of Medicine, Division of Cardiovascular Disease, The University of Alabama at Birmingham, Birmingham, Alabama, USA
    • ,
  • Peter M.T. Wong, MB (ChB, MRCP)

      Affiliations

    • Department of Medicine, Division of Cardiovascular Disease, The University of Alabama at Birmingham, Birmingham, Alabama, USA
    • ,
  • Chumpol Piamsomboon, MD

      Affiliations

    • Department of Medicine, Division of Cardiovascular Disease, The University of Alabama at Birmingham, Birmingham, Alabama, USA
    • ,
  • Sanjay S. Yadav, MD

      Affiliations

    • Department of Medicine, Division of Cardiovascular Disease, The University of Alabama at Birmingham, Birmingham, Alabama, USA
    • ,
  • Larry S. Dean, MD

      Affiliations

    • Department of Medicine, Division of Cardiovascular Disease, The University of Alabama at Birmingham, Birmingham, Alabama, USA
    • ,
  • Jiri J. Vitek, MD

      Affiliations

    • Department of Radiology, The University of Alabama at Birmingham, Birmingham, Alabama, USA

Received 22 July 1997; received in revised form 15 January 1998; accepted 15 January 1998.

Abstract 

Significant carotid stenosis in the presence of an occluded contralateral artery has a poor prognosis with medical therapy alone. Carotid cross clamping during surgical endarterectomy results in critical flow reductions in patients with inadequate collateral flow, and represents a significant risk for procedural strokes. Carotid stenting is being evaluated as an alternative to endarterectomy. We describe the immediate and late outcome of a series of 26 patients treated with carotid stenting in the presence of contralateral carotid occlusion. The mean age of the patients in this group was 65 ± 9 years, 23 (89%) were men and 10 (39%) were symptomatic from the vessel treated. The procedural success of carotid stenting in this group of patients was 96%. The mean diameter stenosis was reduced from 76 ± 15% to 2.8 ± 5%. There was 1 (3.8%) minor stroke in a patient who developed air embolism during baseline angiography. At late follow-up there was no neurologic event in any patient at a mean of 16 ± 9.5 months after the procedure. Thus, carotid stenting of lesions with contralateral occlusion can be performed successfully with a low incidence of procedural neurologic complications and late stroke.

 

PII: S0002-9149(98)00161-1

American Journal of Cardiology
Volume 81, Issue 11 , Pages 1315-1317, 1 June 1998