{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T14:45:36Z","timestamp":1777819536408,"version":"3.51.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2001,8,1]],"date-time":"2001-08-01T00:00:00Z","timestamp":996624000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Endovasc Ther"],"published-print":{"date-parts":[[2001,8]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To review the neurological complications associated with extracranial carotid artery stenting and to preliminarily assess techniques used to manage these complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Between April 1994 and August 2000, 450 patients (270 men; mean age 70.2 years, range 27\u201389) had stents implanted to treat 472 cervical carotid artery stenoses. Over half (257, 57%) of the patients were symptomatic. A variety of stents were implanted percutaneously after predilation of the lesion; a third of the patients received glycoprotein IIb\/IIIa inhibitors intraprocedurally in addition to a standard oral antiplatelet regimen (aspirin and ticlopidine or clopidogrel). Occurrence and management of neurological complications within the 30-day periprocedural period were reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There were 14 (3.1%) transient ischemic attacks (TIAs), 10 (2.2%) minor strokes, and 3 (0.7%) major strokes. Among 6 (1.3%) procedure-related deaths, 4 had neurological causes. The total stroke and death rate was 4.2% (n =19). All the TIAs, 4 of which occurred between 1 and 14 days poststenting, were treated medically, as were the minor strokes, 3 of which occurred &gt;24 hours after stenting. Only 2 minor stroke patients had mild residual upper extremity motor deficits. Intra-arterial thrombolytic therapy was administered in 5 cases (2 major strokes survivors and 3 patients who suffered a neurologically-related death); occlusions were identified in the proximal middle cerebral artery (MCA) in 3 and the distal MCA in 2. Angiographic improvement was noted in 4 (80%), but only the 2 (40%) with distal MCA occlusions did well clinically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Neurological complications following carotid artery stenting are inevitable. The occurrence of minor strokes &gt;24 hours following stenting may indicate a possible late embolic phenomenon, which warrants investigation. Likewise, the marginal efficacy of intra-arterial thrombolytic therapy demonstrates an inability to lyse embolic plaque and underscores the need for effective distal protection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/152660280100800403","type":"journal-article","created":{"date-parts":[[2015,3,19]],"date-time":"2015-03-19T06:14:07Z","timestamp":1426745647000},"page":"341-353","source":"Crossref","is-referenced-by-count":28,"title":["Management of Neurological Complications of Carotid Artery Stenting"],"prefix":"10.1177","volume":"8","author":[{"given":"Michael H.","family":"Wholey","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Interventional Radiology, University of Texas Health Science Center at San Antonio, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark H.","family":"Wholey","sequence":"additional","affiliation":[{"name":"Pittsburgh Vascular Institute, UPMC Shadyside Hospital, Pittsburgh, Pennsylvania, 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