Does a contralateral carotid occlusion adversely impact carotid artery stenting outcomes?

Mark L. Keldahl, Michael S. Park, Manuel Garcia-Toca, Chih Hsiung E Wang, Melina R. Kibbe, Heron E. Rodriguez, Mark D. Morasch, Mark K. Eskandari*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Background: Carotid artery stenting (CAS) has grown as a possible alternative for the treatment of extracranial cerebrovascular disease in the past decade. A preexisting contralateral carotid artery occlusion has been described as a risk factor for inferior outcomes after carotid endarterectomy, but its impact on CAS outcomes is less understood. Methods: A retrospective review of 417 CAS procedures performed between May 2001 and July 2010 at a single center using self-expanding nitinol stents and mechanical embolic protection devices was conducted. Patients were divided into two groups, those with a preexisting contralateral carotid occlusion (group A, n = 39) versus those without a contralateral occlusion (group B, n = 378). Patient demographics and comorbidities as well as 30-day and late death, stroke, and myocardial infarction (MI) rates were analyzed. Mean follow-up was 4 years (range: 0-9.4 years). Results: Overall, mean age of the 314 men and 103 women was 70.5 years. In group A, there were two (5.1%) octogenarians and nine patients (23.1%) with symptomatic disease as compared with group B with 53 (14%) octogenarians and 121 (32%) patients with symptomatic disease. The overall 30-day death, stroke, and MI rates were 0.5%, 1.9%, and 0.7%, respectively. When comparing group A with group B, these results were not significantly different: death (0% vs. 0.5%), stroke (2.6% vs. 1.9%), and MI (0% vs. 0.8%). Long-term outcomes for groups A and B were also not significantly different: death (25.6% vs. 22.2%), stroke (5.3% vs. 3.4%), and MI (15.4% vs. 14%) (p = nonsignificant). Conclusion: A preexisting contralateral carotid artery occlusion does not seem to adversely impact CAS outcomes.

Original languageEnglish (US)
Pages (from-to)40-45
Number of pages6
JournalAnnals of vascular surgery
Volume26
Issue number1
DOIs
StatePublished - Jan 2012

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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