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International Angiology 2012 August;31(4):356-60
Copyright © 2012 EDIZIONI MINERVA MEDICA
lingua: Inglese
Effect of stenting on patients with chronic internal carotid artery occlusion
Xia Z. Y. 1, Yang H. 2, Xu J. X. 1, Zhang M. 3, Qu H. Q. 1, Xu G. L. 3, Yin Q. 3, Wang L. X. 4 ✉
1 Department of Neurology, Liaocheng People’s Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng, Shandong, Republic of China; 2 Department of Neurology, the Third People’s Hospital of Liaocheng, Liaocheng, Shandong, Republic of China; 3 Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, Republic of China; 4 School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, Australia
AIM: Effects of carotid artery stenting (CAS) on patients with chronic internal carotid artery occlusion are unknown.
METHODS: This study included 21 patients who underwent successful CAS treatment and 41 patients who received optimal medical therapy. Modified Rankin Scale (mRS) and cardiocerebral vascular events were compared between CAS and medical therapy group.
RESULTS: The mRS in CAS group was lower than in control group during a 2-year follow up (P<0.05 or 0.01). The combined cerebrovascular events and mortality in study group was lower than in the control group (33.4% vs. 56.1%, P=0.045), but there was no statistically significant difference in the cerebrovascular event (28.6% vs. 46.3%, P=0.088) or mortality rate (4.8% vs. 9.8%, P=0.247) between the two groups. Cox regression analysis revealed that smoking (RR=3.189, 95% CI 1.020-9.968, P=0.046), diabetes (RR=2.717, 95% CI 1.113-6.631, P=0.028), and baseline National Institute of Health stroke scale (RR=2.984, 95% CI 1.049-8.485, P=0.040) were independent risk factors for major cerebrovascular events following CAS.
CONCLUSION: CAS was superior to drug therapy in achieving better functional outcomes in patients with chronic internal carotid artery occlusion. However, CAS was not associated with a statistically significant reduction in cerebrovascular events or mortality. Larger and randomized clinical trials are required to ascertain the long-term benefits of CAS in patients with chronic internal carotid artery occlusion.