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4 . 2023

Long-term results of carotid arteries stenting. Comparison with the CREST study

Abstract

The article analyzes the results of a retrospective analysis of the long-term results of 512 carotid stenting performed in 464 patients with symptomatic and asymptomatic stenoses of the extracranial sections of the internal carotid arteries due to atherosclerosis. It has been shown that the incidence of development of ipsilateral stroke of ischemic type and AMI in the long-term period is lower than similar indicators in the CREST study. Possible reasons for the obtained results are discussed. The topic under consideration will be of interest to specialists in endovascular diagnostics and treatment, cardiovascular surgeons, and neurologists.

Keywords:carotid stenting; stent; cerebral protection devices; filter; proximal protection device; complication rate; immediate results; long-term results; CREST trail

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Volkov S.V., Korobkov А.О., Naumov S.М., Mytsyk S.A., Perekhodov S.N. Long-term results of carotid arteries stenting. Comparison with the CREST study. Clinical and Experimental Surgery. Petrovsky Journal. 2023; 11 (4): 98–105. DOI: https://doi.org/10.33029/2308-1198-2023-11-4-98-105  (in Russian)

References

1.     Bokeria L.A., Stupakov I.N., Gudkova R.G. Analysis of incidence rates of various forms of circulatory system diseases in the federal districts of the Russian Federation. Zdravookhranenie [Health Care]. 2015; (6): 66–75. (in Russian)

2.     Dorn F., Liebig T., Muenzel D., et al. Order of CT stroke protocol (CTA before or after CTP): impact on image quality. Neuroradiology. 2012; 54: 105–12.

3.     Suslina Z.A., Piradov M.A. Stroke: diagnosis, treatment, prevention. 2nd ed. Moscow: MEDpress-inform, 2009. (in Russian)

4.     Esenwa C., Gutierrez J. Secondary stroke prevention: challenges and solutions. Vasc Health Risk Manag. 2015; 11: 437–50.

5.     Barnett H.J., Taylor D.W., Eliasziw M., et al. Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators. N Engl J Med. 1998; 339 (20): 1415–25.

6.     European Carotid Surgery Trialists’ Collaborative Group. Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet. 1998; 351: 1379–87.

7.     Jansen O, Fiehler J, Hartmann M et. al. Protection or nonprotection in carotid stent angioplasty: the influence of interventional techniques on outcome data from the SPACE Trial // Stroke. 2009. Vol. 40. P. 841–846.

8.     Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. Endarterectomy for asymptomatic carotid artery stenosis. JAMA. 1995; 273 (18): 1421–8.

9.     Beebe H.G., Clagett G.P., DeWeese J.A., et al. Assessing risk associated with carotid endarterectomy. A statement for health professionals by an Ad Hoc Committee on Carotid Surgery Standards of the Stroke Council, American Heart Association. Circulation. 1989; 79 (2): 472–3.

10. Hertzer N.R., Ouriel K. Results of carotid endarterectomy: the gold standard for carotid repair. Semin Vasc Surg. 2000; 13 (2): 95–102.

11. Yadav J.S., Wholey M.H., Kuntz R.E., et al. Protected carotid-artery stenting versus endarterectomy in high-risk patients. N Engl J Med. 2004; 351 (15): 1493–501.

12. Brott T.G., Hobson R.W. 2nd, Howard G., et al.; CREST Investigators. Stenting versus endarterectomy for treatment
of carotid-artery stenosis. N Engl J Med. 2010; 363: 11–23.

13. Bokeriya L.A., Pokrovsky A.V., Sokurenko G.Yu. National guidelines for the management of patients with brachiocephalic artery disease. Angiologiya i sosudistaya khirurgiya [Angiology and Vascular Surgery]. 2013; 19 (2): 1–72. (in Russian)

14. Brott T.G., Howard G., Roubin G.S., et al.; CREST Investigators. Long-term results of stenting versus endarterectomy for carotid-artery stenosis. N Engl J Med. 2016; 374 (11): 1021–31.

15. Inzitari D., Eliasziw M., Gates P., et al. The causes and risk of stroke in patients with asymptomatic internal-carotid-artery stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators. N Engl J Med. 2000; 342 (23): 1693–700.

16. Naylor A., Bolia A., Abbott R., et al. Randomized study of carotid angioplasty and stenting versus carotid endarterectomy: a stopped trial. J Vasc Surg. 1998; 28 (2): 326–34.

17. Endovascular versus surgical treatment in patients with carotid stenosis in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): a randomised trial. Lancet. 2001; 357 (9270): 1729–37.

18. Mantese V.A., Timaran C.H., Chiu D. The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST): stenting versus carotid endarterectomy for carotid disease. Stroke. 2010; 41 (10): S31–4.

19. Müller M.D., Gregson J., McCabe D.J.H. et al. Stent Design, Restenosis and Recurrent Stroke After Carotid Artery Stenting in the International Carotid Stenting Study // Stroke. 2019. Vol. 50 N 1. P. 3013–3020.

20. Müller-Hülsbeck S., Schäfer P.J., Charalambous N. et al. Comparison of carotid stents: an in vitro experiment focusing on stent design // J Endovasc Ther. 2009. V. 16. P. 168—177.

21. CAPRIE Steering Committee. A randomised blinded trial of Clopidogrel versus Aspirin in patients at risk of ischaemic events (CAPRIE). Lancet. 1996; 348 (9038): 1329–39.

22. Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol lowering with Simvastatin in 20536 high-risk individuals: a randomised placebo-controlled trial. Lancet. 2002; 360 (9326): 7–22.

23. Paraskevas K.I., Mikhailidis D.P., Liapis C.D., et al. Critique of the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST): flaws in CREST and its interpretation. Eur J Vasc Endovasc Surg. 2013; 45 (6): 539–45.

24. Naggara O., Touzé E., Beyssen B., et al.; EVA-3S Investigators. Anatomical and technical factors associated with stroke or death during carotid angioplasty and stenting: results from the endarterectomy versus angioplasty in patients with symptomatic severe carotid stenosis (EVA-3S) trial and systematic review. Stroke. 2011; 42 (2): 380–8.

25. Heck D., Jost A., Howard G. Stenting the carotid artery from radial access using a Simmons guide catheter. J Neurointerv Surg. 2022; 14 (2): 169–73.

26. Bergeron P. Direct percutaneous carotid access for carotid angioplasty and stenting. J Endovasc Ther. 2015; 22 (1): 135–8.

27. El-Koussy M., Schroth G., Do D.D., et al. Periprocedural embolic events related to carotid artery stenting detected by diffusion-weighted MRI: comparison between proximal and distal embolus protection devices. J Endovasc Ther. 2007; 14: 293–303.

28. Lam R.C. Contemporary review of embolic distal protection strategies in carotid artery stenting. J Invasive Cardiol. 2009; 21: 413–4.

29. Korobkov A.O., Volkov S.V., Bagin S.A. et al. Selection of cerebral protection devices in carotid stenting. Vestnik meditsinskogo instituta «Reaviz»: reabilitatsiya, vrach i zdorov’e [Bulletin of the Medical Institute «Reaviz»: Rehabilitation, Physician and Health]. 2021; 1 (49): 29–37. (in Russian)

30. Kassavin D.S., Clair D.G. An update on the role of proximal occlusion devices in carotid artery stenting. J Vasc Surg. 2017; 65: 271–5.

31. Bosiers M., Deloose K., Verbist J., et al. Carotid artery stenting: which stent for which lesion? Vascular. 2005; 13 (4): 205–10.

32. Nerla R., Castriota F., Micari A., et al. Carotid artery stenting with a new-generation double-mesh stent in three high-volume Italian centres: clinical results of a multidisciplinary approach. EuroIntervention. 2016; 12 (5): e677–83.

33. Calvet D., Mas J.L., Algra A. Carotid stenting: is there an operator effect? A pooled analysis from the carotid stenting trialists’ collaboration. Stroke. 2014; 45 (2): 527–32.

34. Chung J., Kim Y.B., Hong C.K., et al. Blood pressure-lowering effect of carotid artery stenting in patients with symptomatic carotid artery stenosis. Acta Neurochir (Wien). 2014; 156 (1): 69–75.

35. Roubin G. Hemodynamic management during carotid stenting. JACC Cardiovasc Interv. 2019; 12 (9): 883–4.

36. Köklü E., Arslan Ş., Sarıönder Gencer E., Bayar N., Avcı R., Özgünoğlu E.C. Six-year outcomes of carotid artery stenting performed with multidisciplinary management in a single center. Anatol J Cardiol. 2021; 25 (6): 385–94.

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CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

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