Abstract
Internal carotid artery (ICA) stenosis is one of the most common causes of ischaemic stroke. The gold standard in the treatment of ICA stenosis is carotid endarterectomy (CEA), while carotid artery stenting (CAS) is considered as an alternative.
Indications for CAS are restenosis after prior CEA, stenosis after radiotherapy, high position of carotid bifurcation, tandem stenosis, contralateral head nerves palsies, ICA dissection or previous neck surgery. CAS safety has been well studied in many trials.
In our hospital we have long-term experience with CAS. Particular cases are discussed and the best method for ICA stenosis treatment is chosen by a board composed of a neurologist, vascular surgeon and interventional radiologist.
We observe the patients at the neurology department and immediately after CAS, patients are observed at the neuro-intensive care unit for one day. We have our own registry of complications and restenosis cases after CAS, which helps us improve our efforts.
Between 2010 and 2014, we implanted 242 stents into ICA. The 30-day overall mortality and morbidity (death, stroke, acute myocardial infarction) was 4.96%, in the asymptomatic ICA stenosis group it was 2.88%, in symptomatic 7.77%.
We did not find any in-stent restenosis. We consider well-indicated CAS as a safe alternative to CEA.