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

• Treatment of long segment carotid stenosis (≥40 mm) with carotid artery stenting (CAS) has rarely been reported.
• All of our procedures were performed successfully, and the luminal diameter increased significantly post dilatation.
• Our study showed that stenting for long carotid stenosis (≥40 mm) can be beneficial.

BackgroundTreatment 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 resultsBetween 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 27.3 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.ConclusionsOur 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.