Stent-assisted percutaneous angioplasty for extra-cranial carotid disease:experience at Singapore General Hospital
Gogna, A.; Lath, N.; Chang, H.M.; Tan, B.S.; Wong, M.C.; Koh, T.H.; Lim, S.T.; Htoo, M.M.; Lim, W.E.H.
Annals of the Academy of Medicine Singapore 38(9): 756-762
2009
ISSN/ISBN: 0304-4602 PMID: 19816633 Document Number: 632033
This study aims to analyse the results of carotid stenting in a tertiary referral centre in Singapore. Retrospective analysis of all carotid artery stenting (CAS) cases in a single centre from March 1997 to December 2008 was performed. Sixty successful procedures were performed in 61 patients, with bilateral stenting in 1 patient, and 2 failed procedures. The majority were Chinese (78.7%) and males (77.0%), with a high proportion having hypertension (82.0%) and hypercholesterolaemia (78.7%). The majority (91.8%) of patients were high surgical risk candidates, primarily due to cardiac risk factors. Ten patients (16.4%) had prior neck irradiation for nasopharyngeal carcinoma, and 3 patients each (4.9%) had previous endarterectomy and contralateral occlusion. A distal embolic protection device was used in 71.7% of cases. Technical success was 96.8%. The 30-day stroke and death rate was 13.8%, comparable to reported results for this high surgical risk population. CAS is a technically feasible and a relatively safe alternative to endarterectomy to treat extracranial carotid stenosis, especially in patients who are inoperable or at high surgical risk.