Results of carotid artery stenting. Lessons learned in a belgian 'real world' practice

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE/BACKGROUND: Carotid artery stenting (CAS) is a valuable solution for the treatment of carotid artery stenosis in a high-risk patient population for carotid endarterectomy (CEA). In literature however, there are concerns about the death and stroke rates of CAS in the 'real world' practice. Since Belgium is a small country with a broad offer of medical care, and there is no reimbursement for CAS, only small numbers of patients can be treated per vascular department.

METHODS: In our department 45 CAS were performed from January 2006 until May 2018. Patient characteristics, indication for treatment and choice of treatment, minor stroke, major stroke and death rates were analyzed retrospectively.

RESULTS: Of these patients 8/45 (18%) had a symptomatic carotid artery stenosis and 37/45 (82%) had an asymptomatic stenosis. A total minor stroke rate of 3/45 (6.6%) was recorded, but no major stroke (0%) or death (0%). Of the 37 patients who were asymptomatic at the start, 1 suffered a minor stroke (1/37, 2.7%) peri-operatively.

CONCLUSION: Real world data from a low volume center show that CAS performed in patients with high risk for CEA yields acceptable outcome that is comparable to the literature. Since CAS is a delicate procedure we advice to centralize the procedure to an dedicated experienced interventionalist and to perform rigorous quality control of your 'real world' data.

Original languageEnglish
Pages (from-to)328-333
Number of pages6
JournalActa Chirurgica Belgica
Volume122
Issue number5
Early online date5 Apr 2021
DOIs
Publication statusPublished - 3 Sep 2022

Bibliographical note

Funding Information:
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Publisher Copyright:
© 2021 The Royal Belgian Society for Surgery.

Copyright:
Copyright 2022 Elsevier B.V., All rights reserved.

Keywords

  • 'real world' practice
  • Carotid Artery Stenting
  • high-risk population for CEA

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