Stent placement for treatment of long-segment (≥40 mm) carotid atherosclerotic stenosis: Results and long-term follow-up in a single-center experience

Background: Treatment of long segment carotid stenosis (>= 40 mm) with carotid artery stenting (CAS) has rarely been reported. In randomized trials, use of longer stents (>40 mm) has been associated with adverse clinical events. Here, we report our preliminary experience on the stent length and outcome in treating long segment carotid arterial stenosis. Methods and results: Between August 2003 and February 2013, 22 patients with long segment stenosis of the carotid artery were treated by CAS. The mean stent length was 58.5 mm (50-60 mm). The procedures were successful in all patients, and all reported remarkable relief of symptoms immediately after stent placement. Complications included 1 case of cerebral hemorrhage and one death from myocardial infarction at 10 months. The mean follow up was 273 months (10-60 months). One follow-up was lost. 2 patients had late stent thrombosis at 22 and 36 months by CTA follow-up. 18 patients had persistent relief, and angiography/CTA showed normal carotid flow. Conclusions: Our study showed that stenting for long carotid stenosis (>= 40 mm) can be beneficial. Large scale clinical trial is needed to further evaluate its efficacy and safety. (C) 2014 Published by Elsevier B.V.