Safety and Efficacy of Carotid Artery Stenting without the Use of Protective Embolic Devices

Abstract Background Stroke is the third most common cause of disability and second most common cause of death worldwide. Extra cranial carotid stenosis accounts for about 15-20% of cerebral ischemic events. Aim of the Work To evaluate the efficacy, and safety of carotid artery stenting without using cerebral protection device in selected patients with symptomatic high risk carotid artery stenosis. Patients and Methods All available patients during the study duration will be included in the study, NIR unit archives of all available carotid artery stenosis cases meeting the inclusion who underwent carotid artery stenting without using embolic protection devices as well as patients who will be referred to NIR Unit with carotid artery stenosis meeting the inclusion and exclusion criteria and candidates for the procedure in the proceeding 6 months. Results In our study of assessing safety and efficacy of unprotected CAS all cases were clinically assessed using the NIHSS as a baseline before CAS. Immediately after the intervention, seventy-eight cases (97.5%) had no change in their initial NIHSS and two cases (2.5%) showed mild deterioration of the NIHSS with no cases showing major disabling strokes nor neurological related deaths peri procedurally and during follow up period. Conclusion Carotid stenting without the use of embolic protection devices performed by skillful experienced hands can achieve satisfactory safety and efficacy outcomes as long as we rely on tailored approach for patient selection especially in settings of low resources.