Carotid Stenting and Angioplasty in Iraqi Patients Presenting with Stroke Using Drug Eluting Coronary Stents and Peripheral Vascular Stents

Stroke causes death andlongterm disability. Heart disease and cancer are considered the first 2 causes followed by stroke as third cause. The aim of the study is to assesscarotid stentingin patients presenting with stroke using drug eluting coronary stents (type Biomatrix and type Everolemus)and peripheral vascular stents.

Seventy four patients with stroke (ischeamic)were enrolled in the study. The male patients were(42)and the female patients(32)with age between (41–82).Patients were examined neurologically and carotid Doppler study was done before the neurointervention procedures and during followup for one to sixmonths. Distal protection device (filter wire) was used during all the cases.

Technical access and success was achieved in all the seventy four patients using transfemoral route. There was no neurological periprocedural complications. The coronary drug eluting stents were used in forty patients, while the peripheral vascular stents were used in thirty four patients only. The degree of stenosis using drug eluting coronary stents was reduced from 80%(as a mean)to 30%(as a mean)immediately after the procedure, while there was full dilatation on using the peripheral vascular stents.

Carotid stenting and angioplasty results were best using the peripheral vascular stents because the peripheral vascular stents are more flexible with good sizes in comparism to the size of the internal carotid artery.

The coronary drug eluting stents can be displaced from its deployment site in the Internal carotid artery especially if small sizes used. Flexible stents such as the peripheral stents are good for the internal carotid artery because the neck is highly movable area. The carotid walstents (Boston Scientific)areself expanding and also flexible stents.