Abstract WP28: Long-Term Outcome of Carotid Artery Stenting in Patients of Atherosclerotic Carotid Artery Disease : A 10-year Experience of a Single Tertiary Center in Korea

Background & Objective Considering an increasing incidence of carotid artery disease in Asian subjects, the data showing long-term outcome of carotid artery stenting(CAS) from Asian population is mandatory. However, long-term outcome of CAS in Asian population have rarely been reported. The purpose of this study is to evaluate long-term results of CAS from the 10-year experience of a single center. Methods Patients undergoing CAS between May 2002 and May 2012 in our hospital were retrospectively reviewed. We abstracted demographic, clinical, and medical factors. In addition, plaque characteristics and angiographic factors were also evaluated. Neck CT angiography was followed-up every 6 months after CAS. We investigated the cumulative long-term incidence of carotid restenosis and risk factors for the development of restenosis. Results A total of 262 arteries (248 patients, mean age of 72.1±7.6 years, 81.7% male) were analysed. The degree of mean carotid stenosis was 70.9±17.5%. Symptomatic lesions were 178 (67.9%), and 84 (32.1%) arteries were asymptomatic. Predilatation (97.3%) and post-dilatation (42.4%) was performed during procedures. Embolic protection devices were used in 233 (88.9%) cases. During procedures, In-situ thrombosis with embolic infarction or TIA occurred in 6 (2.3%) and 10 (3.8%) cases, respectively. During a median follow-up time of 27.5 months, restenosis (> 50% stenosis) was detected in 18 (6.9%) of 262 arteries (asymptomatic, 16; symptomatic, 2). Restenotic lesions were treated in 6 (2.3%) cases with angioplasty including 2 symptomatic patients. The percentage of residual stenosis after stenting was significantly related to a risk of restenosis (p<0.02). Discussion Restenosis rate in this study was comparable to those of other single or multi-center trials in Western population. Our long-term results may validate CAS as a durable procedure for stroke prevention in patients with carotid artery stenosis in Korea.