Outcomes Of Carotid Artery Stenting Without Embolic Protection in Yemen: A Resource-Constrained Experience
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BACKGROUND
Carotid Artery stenting (CAS) have been reported to be safe and effective option for treating carotid atherosclerotic diseases. The published data support the use of embolic protection devices (EPDs) to reduce periprocedural stroke. However, reports and studies from resource limited countries are scarce. This study aimed to evaluate the outcome of CAS procedures without EPDs in Yemen as one of the lowest-income countries.
METHODS
This is a retrospective cohort study regarding carotid artery stenting (CAS) for symptomatic carotid artery stenosis that was conducted at the stroke center of and American Modern Hospital (AMH) during the period from March 2023 to March 2025. All Patients with symptomatic carotid artery stenosis were included in the study. CAS procedures were performed by a single interventional neurologist. The primary outcome included a 30-day periprocedural mortality, stroke, and myocardial infarction or arrythmia. Any other complications are considered secondary outcomes.
RESULTS
A total of 62 (53 males) patients included in this study, mean age 60.2 ± 9.68 years. All Patients had symptomatic carotid artery stenosis. Technical success rate was 100%. (%). One patient developed transient dysarthria but DW-MRI was negative. Significant bradycardia occurred in two patients and responded immediately to atropine. Three patients developed mild local hematoma and one patient had femoral pseudoaneurysm. Closed-Cell Carotid Wall Stent (Boston Scientific) was used as a single stent in all patients.
CONCLUSION
CAS conducted by a trained interventional neurologist without EPDs, demonstrates a low complication rate and it is effective and safe option in countries with-limited resources.
