Determination of carotid artery endovascular treatment effects in carotid artery stenosis

Cerebrovascular disease, is the most important cause of death after cancer and heart disease in adults all over the world. One of the most important cause of stroke is carotid artery stenosis. The purpose of this study, obtaining a retrospective review of the endovascular treatment of 114 patients due to the carotid artery stenosis, in our center, between the years of 2000-2014, and comparing the data with the existing literature. In this study, 114 patients with carotid endovascular stenting after selective carotid angiography in Baskent University Faculty of Medicine, Ankara Hospital Interventional Radiology Unit, between 01/01/2000-01/02/2014, were examined. In total 83 patients were male (72.8%) and 31 patirnts were women (27.2%). The age ranges of the all patients varies between 41 and 86 years (mean 69 ± 8.7). Review was retrospective and patient demographics (age, gender, other systemic disease), pre-procedural stenosis rates and stenosis of the side, the plate type, used type of stent during the procedure, anticoagulation therapy, embolic protection system (EPD), postdilatation and predilatation, the vessel occlusion device, the success rate in stent placement, early complications (<30 days), the incidence of restenosis in stents, 6 th month 1 st year, 2 nd year, 5 th year checks were evaluated. Developing carotid artery stenosis in patients with hypertension accompanied ratio of women to men is higher (p <0.01). There were no significant differences in early complications between the ulcerated plaques and the others (p> 0.05). Development of early complications were observed to be higher proportionally (p=0.062) in patients who were used Nitinol stents, according to the patients who were used the Wallstent. The technique success was great. In all patients stents were carried out successfully. Within the first 30 days embolic events and infarct formation were observed in 13 patients (11.4%). One of these patients died due to embolic events. In the late period of controls, development of stenosis viewed at different levels. Stenosis were observed in different levels in 11 of 97 patients (11,3%) at available controls. In 4 of these patients (4,1%) were found to developed complete occlusion. Also, in 4 patients (4.1%) requiring only less than 50% stenosis development was present, and 3 of the patients (3.09%) over 50% stenosis development has been identified. The stent patency rates were 98% at the end of the first year, 96 % at the end of the second year, 87 % at the end of the fifth year respectively. Average time of developing stenosis was calculated as 4.86 ± 0.11 years. Stent patency rates and the early complication rates of the endovascular treatment of carotid artery stenosis applying in our center were similar with the studies. However, the increasing number of patients and prolonging the follow-up treatment times, we may have a better idea about the efficacy and complications of the carotid artery stenting.