Stent placement for treatment of long segment (≥80 mm) carotid artery stenosis in patients with Takayasu disease

Abstract

Purpose: To evaluate the effectiveness and safety of carotid artery stent (CAS) placement for treatment of long segment stenosis in patients with Takayasu arteritis.

Materials and methods: Between January 2002 and February 2012, all patients with Takayasu arteritis found to have long segment (≥80 mm) carotid artery stenoses at a single institution were retrospectively analyzed. Five patients treated by CAS placement with either long or multiple self-expandable stents were included. All patients had focal neurologic symptoms, including three strokes and two transient ischemic attacks (TIAs). Six self-expanding stents were used in five patients. The mean follow-up period was 19.2 months (range, 6-30 mo); all patients had clinical evaluation, laboratory examination, and vascular imaging follow-up.

Results: Improvement in clinical symptoms was shown after successful angioplasty. There were no perioperative or in-hospital deaths. Four patients exhibited persistent relief, and repeated angiography or computed tomography (CT) angiography showed normal flow. One patient stopped taking her medications after CAS placement and became symptomatic 8 months later as a result of a severe in-stent stenosis.

Conclusions: CAS placement was shown to be a feasible option for treating long segment (≥80 mm) stenosis of carotid arteries in patients with Takayasu arteritis with encouraging results.