Percutaneous Stenting of the Internal Carotid Artery: The European CAST I Study

Abstract

Purpose: To report the results of a multicenter safety trial of percutaneous carotid stenting performed by vascular surgeons. Methods: Symptomatic or asymptomatic patients ≥ 65 years of age with internal carotid artery (ICA) stenoses ≥ 70% and ≤ 2-cm long were eligible for enrollment. The procedures were performed in an operating room with the choice of anesthesia and the percutaneous access site at the discretion of the surgeon. Only Palmaz stents were used. Results: From January 1, 1996 to December 31, 1997, 99 patients (74 men, mean age 70 years, range 51 to 94) were enrolled in the study. More than half (57 of 99 patients) were asymptomatic. The direct cervical approach was used predominantly (97%). Three (3%) cases were converted to surgery for inability to access the artery or deploy the stent (technical success 97%). No perioperative death or myocardial infarction was reported. Six (6%) procedural complications included 1 reversible arterial spasm, 2 dissections, 1 cervical hematoma, and 2 residual stenoses. One neurological event reversed within 7 days(1% minor stroke rate) and 4 (4%) transient ischemic attacks resolved within 24 hours. One (1%) asymptomatic early occlusion occurred 2 days postoperatively. No neurological event was observed in the 1- to 24-month follow-up (mean 13 months). Two (2%) patients died of nonprocedurally related causes. No stent compression was seen, but 1 asymptomatic occlusion and 3 asymptomatic, non-flow-limiting restenoses (2 < 40%, 1 at 60%) were found within 1 year (3% restenosis rate on an intention-to-treat basis). Patency was 98% at 1 year. Conclusions: The results of this trial support the contention that carotid stenting of short ICA lesions can be performed with a low neurological complication rate.

Probing star formation across cosmic time with absorption-line systems

“…This choice was mainly driven by practical constraints: among the dominant ions in H I gas only Mg II could be studied from the ground at low redshifts (z < 2). Following the first confirmation of a Mg II absorber-galaxy connection by Bergeron (1986), a considerable amount of work has focused on revealing the nature and origin of these systems. Mg II is known to be a tracer of galactic haloes, routinely seen up to about 50 kpc around galaxies.…”

On the observed - correlation in Sloan Digital Sky Survey QSO spectra

“…Mg II absorbers are routinely found in the vicinities ( 100 kpc) of distant galaxies and provide a convenient probe of galactic haloes at high redshifts (e.g. Bergeron 1986;Steidel, Dickinson & Persson 1994;Kacprzak et al 2008;Gauthier & Chen 2011). However, their physical origin, whether the absorbers arise in infalling clouds, outflows from nearby star-forming regions or a combination thereof, is unclear.…”

The dark matter haloes and host galaxies of Mg ii absorbers at z∼ 1

“…E-mail: britt.lundgren@yale.edu †Alfred P. Sloan Foundation Fellow. Bergeron 1986;Cristiani, Danziger & Shaver 1987;Yanny et al 1987;Bergeron & Boissé 1991;Le Brun et al 1993;Steidel 1993;Steidel, Dickinson & Persson 1994), but whether the absorbing gas primarily traces the cool extended regions of dark matter (DM) haloes, dwarf satellite galaxies, galactic discs or supernovae-driven outflows remains an active matter of debate.…”