Transfemoral endovascular treatment of proximal common carotid artery lesions: A single-center experience on 153 lesions

A and B, Successful PTA of the right proximal common carotid artery of a 51-year-old female, asymptomatic patient. Patient had follow-up duplex scan following previous internal carotid endarterectomy. Duplex scan diagnosed 90% stenosis (PSV 450 cm/s) on the proximal part of right CCA. The patient remained neurologically negative throughout the follow-up period. The last follow-up duplex scan at 17 months showed patent CCA with no indication of restenosis.

Successful PTA and stent (8 × 18 mm Genesis, Cordis Corp, Miami, Fla) deployment in the left ostial lesion of common carotid of a 76-year-old asymptomatic female patient. Follow-up duplex scan showed no restenosis after 18 months follow-up. A, Angiography revealed 80% stenosis at the origin of the left CCA. B, Control angiography after stent implantation. Follow-up duplex screening showed no restenosis at 18 months.

A, Kaplan-Meier analysis of cumulative patency rate for 120 proximal common carotid artery interventions, excluding initial failures. Since the direct visualization of the proximal part of the common carotid arteries by carotid duplex scan was not always possible during follow-up, we refer to “patency rate” rather than “restenosis-free patency rate” in our analysis. B, Kaplan-Meier curves of primary cumulative patency rate for 34 proximal common carotid artery angioplasty and 86 proximal common carotid artery stent implantation. Log rank test was used to compare primary cumulative patency rate between PTA and PTA/stent groups. (P = .825). C, Kaplan-Meier curves of secondary cumulative patency rate for angioplasty and stent implantation. Log rank test was used to compare secondary cumulative patency rate between PTA and PTA/stent groups (P = .680).