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Long-term Outcomes after Carotid Stent Placement for Treatment of Carotid Artery Dissection

 

作者: Amon Liu,   Richard Paulsen,   Mary Marcellus,   Gary Steinberg,   Michael Marks,  

 

期刊: Neurosurgery  (OVID Available online 1999)
卷期: Volume 45, issue 6  

页码: 1368-1368

 

ISSN:0148-396X

 

年代: 1999

 

出版商: OVID

 

关键词: Carotid artery diseases;Stenting

 

数据来源: OVID

 

摘要:

OBJECTIVETo assess the long-term outcomes after stent placement for the treatment of carotid artery dissections.METHODSBetween 1992 and 1998, seven patients underwent stenting procedures for treatment of extracranial carotid artery dissections resulting from various causes, including trauma (n = 2), iatrogenesis (n = 2), spontaneous development (n = 2), and fibromuscular dysplasia (n = 1). Stenting procedures were performed for large, nonhealing, dissection-induced pseudoaneurysms (four cases) or severe preocclusive stenosis (three cases). A total of 11 stents were placed (Palmaz stents, n = 8; Wallstents, n = 3). Radiological follow-up examinations were performed after a mean period of 17.7 months (range, 1–67 mo), using conventional or computed tomographic angiography. Clinical follow-up data were obtained after a mean period of 42.9 months (range, 13–72 mo).RESULTSAll stent placements resulted in complete resolution of dissection-induced stenosis. For two of the four patients with aneurysms, the lesions occluded spontaneously at the time of the procedure. The third patient required coil embolization of the pseudoaneurysm. One patient exhibited progressive shrinkage of the aneurysm in serial follow-up examinations, with healing after 18 months. No clinical complications were associated with the procedures. One patient exhibited progression to asymptomatic occlusion 3 months after stenting. The remaining six patients exhibited no significant changes in luminal diameters. All patients remained in clinically stable condition, with no ischemic symptoms, during more than 3.5 years (mean period) of follow-up monitoring.CONCLUSIONThis experience suggests that stents placed for treatment of extracranial carotid artery dissections remain patent and patients remain free of symptoms on a long-term basis. Additional studies will be required to determine the optimal types of stents and intervals for follow-up monitoring using imaging.

 



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