Middle and Distal Common Carotid Artery Stenting: Long-Term Patency Rates and Risk Factors for In-Stent Restenosis
Purpose In the absence of literature data, we aimed to determine the long-term patency rates of middle/distal common carotid artery (CCA) stenting and to investigate predisposing factors in the development of in-stent restenosis (ISR). Materials and Methods Fifty-one patients (30 males, median age 6...
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| Veröffentlicht in: | Cardiovascular and interventional radiology 2020-08, Vol.43 (8), p.1134-1142 |
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| creator | Vértes, Miklós Nguyen, Dat T. Székely, György Bérczi, Ákos Dósa, Edit |
| description | Purpose
In the absence of literature data, we aimed to determine the long-term patency rates of middle/distal common carotid artery (CCA) stenting and to investigate predisposing factors in the development of in-stent restenosis (ISR).
Materials and Methods
Fifty-one patients (30 males, median age 63.5 years), who underwent stenting with 51 self-expandable stents for significant (≥ 60%) stenosis of the middle/distal CCA, were analyzed retrospectively. Patient (atherosclerotic risk factors, comorbidities, medications), vessel (elongation), lesion (stenosis grade, length, calcification, location), and stent characteristics (material, diameter, length, fracture) were examined. Duplex ultrasonography was used to monitor stent patency. The Mann–Whitney
U
and Fisher’s exact tests, Kaplan–Meier analyses, and a log-rank test were used statistically.
Results
The median follow-up time was 35 months (interquartile range, 20–102 months). Significant (≥ 70%) ISR developed in 14 patients (27.5%; stenosis,
N
= 10; entire CCA occlusion,
N
= 4). Primary patency rates were 98%, 92%, 83%, 73%, and 61% at 6, 12, 24, 60, and 96 months, respectively. Reintervention was performed in six patients (11.8%) with nonocclusive ISR. Secondary patency rates were 100% at 6 and 12 months and 96% at 24, 60, and 96 months. In-stent restenosis developed more frequently (
P
|
| doi_str_mv | 10.1007/s00270-020-02522-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7369259</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2424817113</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-d904f510a5e735d0813a3ded1a22f2ba1d77b6c7cc0dcf17f54d3a0e7b8bcba73</originalsourceid><addsrcrecordid>eNp9kU1vEzEQhi1ERdPCH-CALHHhYjr-Wm84IFWhhUpBoFAkbpbX9gaXXbvYG6T8e9ykH8CBg_VKnmfemdGL0HMKrymAOikATAEBdvMkY0Q-QjMqOCPQNt8eoxlQJQiVkh6io1KuAKhsmXyCDjkTAuYNm6H8MTg3eGyiw-9CmcyAF2kcU8QLk9MUHD7Nk89b_GXycQpx_QYvU1yTS59H_NnUT7vFq6plZ7EK5Qc-N3ZKueA-ZXwRya4Tr3ypmkooT9FBb4bin93qMfp6fna5-ECWn95fLE6XxAolJuLmIHpJwUivuHTQUm64844axnrWGeqU6hqrrAVne6p6KRw34FXXdrYzih-jt3vf6003emfrFtkM-jqH0eStTibovysxfNfr9Esr3syZnFeDV7cGOf3c1P31GIr1w2CiT5uimYCGgxSyrejLf9CrtMmxnlcpJlqqKOWVYnvK5lRK9v39MhT0TaR6H6mukepdpFrWphd_nnHfcpdhBfgeKLUU1z4_zP6P7W_5ca2a</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2424817113</pqid></control><display><type>article</type><title>Middle and Distal Common Carotid Artery Stenting: Long-Term Patency Rates and Risk Factors for In-Stent Restenosis</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Vértes, Miklós ; Nguyen, Dat T. ; Székely, György ; Bérczi, Ákos ; Dósa, Edit</creator><creatorcontrib>Vértes, Miklós ; Nguyen, Dat T. ; Székely, György ; Bérczi, Ákos ; Dósa, Edit</creatorcontrib><description>Purpose
In the absence of literature data, we aimed to determine the long-term patency rates of middle/distal common carotid artery (CCA) stenting and to investigate predisposing factors in the development of in-stent restenosis (ISR).
Materials and Methods
Fifty-one patients (30 males, median age 63.5 years), who underwent stenting with 51 self-expandable stents for significant (≥ 60%) stenosis of the middle/distal CCA, were analyzed retrospectively. Patient (atherosclerotic risk factors, comorbidities, medications), vessel (elongation), lesion (stenosis grade, length, calcification, location), and stent characteristics (material, diameter, length, fracture) were examined. Duplex ultrasonography was used to monitor stent patency. The Mann–Whitney
U
and Fisher’s exact tests, Kaplan–Meier analyses, and a log-rank test were used statistically.
Results
The median follow-up time was 35 months (interquartile range, 20–102 months). Significant (≥ 70%) ISR developed in 14 patients (27.5%; stenosis,
N
= 10; entire CCA occlusion,
N
= 4). Primary patency rates were 98%, 92%, 83%, 73%, and 61% at 6, 12, 24, 60, and 96 months, respectively. Reintervention was performed in six patients (11.8%) with nonocclusive ISR. Secondary patency rates were 100% at 6 and 12 months and 96% at 24, 60, and 96 months. In-stent restenosis developed more frequently (
P
< .001) in patients with hyperlipidemia; primary patency rates were also significantly worse (Chi-square, 11.08; degrees of freedom, 1;
P
< .001) in patients with hyperlipidemia compared to those without.
Conclusion
Stenting of the middle/distal CCA can be performed with acceptable patency rates. If intervention is unequivocally needed, patients with hyperlipidemia will require closer follow-up care.
Level of Evidence
Level 3, Local non-random sample.</description><identifier>ISSN: 0174-1551</identifier><identifier>ISSN: 1432-086X</identifier><identifier>EISSN: 1432-086X</identifier><identifier>DOI: 10.1007/s00270-020-02522-5</identifier><identifier>PMID: 32440962</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Aged ; Arterial Interventions ; Arterial Occlusive Diseases - diagnostic imaging ; Arterial Occlusive Diseases - epidemiology ; Arterial Occlusive Diseases - pathology ; Arteriosclerosis ; Atherosclerosis ; Calcification ; Cardiology ; Carotid arteries ; Carotid artery ; Carotid Artery, Common - diagnostic imaging ; Carotid Artery, Common - pathology ; Carotid Artery, Common - surgery ; Clinical Investigation ; Constriction, Pathologic ; Diagnostic Imaging - methods ; Elongation ; Female ; Follow-Up Studies ; Humans ; Hyperlipidemia ; Imaging ; Implants ; Kaplan-Meier Estimate ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Nuclear Medicine ; Occlusion ; Radiology ; Rank tests ; Recurrence ; Restenosis ; Retrospective Studies ; Risk analysis ; Risk Assessment ; Risk Factors ; Stenosis ; Stents ; Treatment Outcome ; Ultrasound ; Vascular Patency</subject><ispartof>Cardiovascular and interventional radiology, 2020-08, Vol.43 (8), p.1134-1142</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-d904f510a5e735d0813a3ded1a22f2ba1d77b6c7cc0dcf17f54d3a0e7b8bcba73</citedby><cites>FETCH-LOGICAL-c474t-d904f510a5e735d0813a3ded1a22f2ba1d77b6c7cc0dcf17f54d3a0e7b8bcba73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00270-020-02522-5$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00270-020-02522-5$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32440962$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vértes, Miklós</creatorcontrib><creatorcontrib>Nguyen, Dat T.</creatorcontrib><creatorcontrib>Székely, György</creatorcontrib><creatorcontrib>Bérczi, Ákos</creatorcontrib><creatorcontrib>Dósa, Edit</creatorcontrib><title>Middle and Distal Common Carotid Artery Stenting: Long-Term Patency Rates and Risk Factors for In-Stent Restenosis</title><title>Cardiovascular and interventional radiology</title><addtitle>Cardiovasc Intervent Radiol</addtitle><addtitle>Cardiovasc Intervent Radiol</addtitle><description>Purpose
In the absence of literature data, we aimed to determine the long-term patency rates of middle/distal common carotid artery (CCA) stenting and to investigate predisposing factors in the development of in-stent restenosis (ISR).
Materials and Methods
Fifty-one patients (30 males, median age 63.5 years), who underwent stenting with 51 self-expandable stents for significant (≥ 60%) stenosis of the middle/distal CCA, were analyzed retrospectively. Patient (atherosclerotic risk factors, comorbidities, medications), vessel (elongation), lesion (stenosis grade, length, calcification, location), and stent characteristics (material, diameter, length, fracture) were examined. Duplex ultrasonography was used to monitor stent patency. The Mann–Whitney
U
and Fisher’s exact tests, Kaplan–Meier analyses, and a log-rank test were used statistically.
Results
The median follow-up time was 35 months (interquartile range, 20–102 months). Significant (≥ 70%) ISR developed in 14 patients (27.5%; stenosis,
N
= 10; entire CCA occlusion,
N
= 4). Primary patency rates were 98%, 92%, 83%, 73%, and 61% at 6, 12, 24, 60, and 96 months, respectively. Reintervention was performed in six patients (11.8%) with nonocclusive ISR. Secondary patency rates were 100% at 6 and 12 months and 96% at 24, 60, and 96 months. In-stent restenosis developed more frequently (
P
< .001) in patients with hyperlipidemia; primary patency rates were also significantly worse (Chi-square, 11.08; degrees of freedom, 1;
P
< .001) in patients with hyperlipidemia compared to those without.
Conclusion
Stenting of the middle/distal CCA can be performed with acceptable patency rates. If intervention is unequivocally needed, patients with hyperlipidemia will require closer follow-up care.
Level of Evidence
Level 3, Local non-random sample.</description><subject>Aged</subject><subject>Arterial Interventions</subject><subject>Arterial Occlusive Diseases - diagnostic imaging</subject><subject>Arterial Occlusive Diseases - epidemiology</subject><subject>Arterial Occlusive Diseases - pathology</subject><subject>Arteriosclerosis</subject><subject>Atherosclerosis</subject><subject>Calcification</subject><subject>Cardiology</subject><subject>Carotid arteries</subject><subject>Carotid artery</subject><subject>Carotid Artery, Common - diagnostic imaging</subject><subject>Carotid Artery, Common - pathology</subject><subject>Carotid Artery, Common - surgery</subject><subject>Clinical Investigation</subject><subject>Constriction, Pathologic</subject><subject>Diagnostic Imaging - methods</subject><subject>Elongation</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Hyperlipidemia</subject><subject>Imaging</subject><subject>Implants</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Nuclear Medicine</subject><subject>Occlusion</subject><subject>Radiology</subject><subject>Rank tests</subject><subject>Recurrence</subject><subject>Restenosis</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Stenosis</subject><subject>Stents</subject><subject>Treatment Outcome</subject><subject>Ultrasound</subject><subject>Vascular Patency</subject><issn>0174-1551</issn><issn>1432-086X</issn><issn>1432-086X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU1vEzEQhi1ERdPCH-CALHHhYjr-Wm84IFWhhUpBoFAkbpbX9gaXXbvYG6T8e9ykH8CBg_VKnmfemdGL0HMKrymAOikATAEBdvMkY0Q-QjMqOCPQNt8eoxlQJQiVkh6io1KuAKhsmXyCDjkTAuYNm6H8MTg3eGyiw-9CmcyAF2kcU8QLk9MUHD7Nk89b_GXycQpx_QYvU1yTS59H_NnUT7vFq6plZ7EK5Qc-N3ZKueA-ZXwRya4Tr3ypmkooT9FBb4bin93qMfp6fna5-ECWn95fLE6XxAolJuLmIHpJwUivuHTQUm64844axnrWGeqU6hqrrAVne6p6KRw34FXXdrYzih-jt3vf6003emfrFtkM-jqH0eStTibovysxfNfr9Esr3syZnFeDV7cGOf3c1P31GIr1w2CiT5uimYCGgxSyrejLf9CrtMmxnlcpJlqqKOWVYnvK5lRK9v39MhT0TaR6H6mukepdpFrWphd_nnHfcpdhBfgeKLUU1z4_zP6P7W_5ca2a</recordid><startdate>20200801</startdate><enddate>20200801</enddate><creator>Vértes, Miklós</creator><creator>Nguyen, Dat T.</creator><creator>Székely, György</creator><creator>Bérczi, Ákos</creator><creator>Dósa, Edit</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200801</creationdate><title>Middle and Distal Common Carotid Artery Stenting: Long-Term Patency Rates and Risk Factors for In-Stent Restenosis</title><author>Vértes, Miklós ; Nguyen, Dat T. ; Székely, György ; Bérczi, Ákos ; Dósa, Edit</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-d904f510a5e735d0813a3ded1a22f2ba1d77b6c7cc0dcf17f54d3a0e7b8bcba73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Arterial Interventions</topic><topic>Arterial Occlusive Diseases - diagnostic imaging</topic><topic>Arterial Occlusive Diseases - epidemiology</topic><topic>Arterial Occlusive Diseases - pathology</topic><topic>Arteriosclerosis</topic><topic>Atherosclerosis</topic><topic>Calcification</topic><topic>Cardiology</topic><topic>Carotid arteries</topic><topic>Carotid artery</topic><topic>Carotid Artery, Common - diagnostic imaging</topic><topic>Carotid Artery, Common - pathology</topic><topic>Carotid Artery, Common - surgery</topic><topic>Clinical Investigation</topic><topic>Constriction, Pathologic</topic><topic>Diagnostic Imaging - methods</topic><topic>Elongation</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Hyperlipidemia</topic><topic>Imaging</topic><topic>Implants</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Nuclear Medicine</topic><topic>Occlusion</topic><topic>Radiology</topic><topic>Rank tests</topic><topic>Recurrence</topic><topic>Restenosis</topic><topic>Retrospective Studies</topic><topic>Risk analysis</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Stenosis</topic><topic>Stents</topic><topic>Treatment Outcome</topic><topic>Ultrasound</topic><topic>Vascular Patency</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vértes, Miklós</creatorcontrib><creatorcontrib>Nguyen, Dat T.</creatorcontrib><creatorcontrib>Székely, György</creatorcontrib><creatorcontrib>Bérczi, Ákos</creatorcontrib><creatorcontrib>Dósa, Edit</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cardiovascular and interventional radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vértes, Miklós</au><au>Nguyen, Dat T.</au><au>Székely, György</au><au>Bérczi, Ákos</au><au>Dósa, Edit</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Middle and Distal Common Carotid Artery Stenting: Long-Term Patency Rates and Risk Factors for In-Stent Restenosis</atitle><jtitle>Cardiovascular and interventional radiology</jtitle><stitle>Cardiovasc Intervent Radiol</stitle><addtitle>Cardiovasc Intervent Radiol</addtitle><date>2020-08-01</date><risdate>2020</risdate><volume>43</volume><issue>8</issue><spage>1134</spage><epage>1142</epage><pages>1134-1142</pages><issn>0174-1551</issn><issn>1432-086X</issn><eissn>1432-086X</eissn><abstract>Purpose
In the absence of literature data, we aimed to determine the long-term patency rates of middle/distal common carotid artery (CCA) stenting and to investigate predisposing factors in the development of in-stent restenosis (ISR).
Materials and Methods
Fifty-one patients (30 males, median age 63.5 years), who underwent stenting with 51 self-expandable stents for significant (≥ 60%) stenosis of the middle/distal CCA, were analyzed retrospectively. Patient (atherosclerotic risk factors, comorbidities, medications), vessel (elongation), lesion (stenosis grade, length, calcification, location), and stent characteristics (material, diameter, length, fracture) were examined. Duplex ultrasonography was used to monitor stent patency. The Mann–Whitney
U
and Fisher’s exact tests, Kaplan–Meier analyses, and a log-rank test were used statistically.
Results
The median follow-up time was 35 months (interquartile range, 20–102 months). Significant (≥ 70%) ISR developed in 14 patients (27.5%; stenosis,
N
= 10; entire CCA occlusion,
N
= 4). Primary patency rates were 98%, 92%, 83%, 73%, and 61% at 6, 12, 24, 60, and 96 months, respectively. Reintervention was performed in six patients (11.8%) with nonocclusive ISR. Secondary patency rates were 100% at 6 and 12 months and 96% at 24, 60, and 96 months. In-stent restenosis developed more frequently (
P
< .001) in patients with hyperlipidemia; primary patency rates were also significantly worse (Chi-square, 11.08; degrees of freedom, 1;
P
< .001) in patients with hyperlipidemia compared to those without.
Conclusion
Stenting of the middle/distal CCA can be performed with acceptable patency rates. If intervention is unequivocally needed, patients with hyperlipidemia will require closer follow-up care.
Level of Evidence
Level 3, Local non-random sample.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>32440962</pmid><doi>10.1007/s00270-020-02522-5</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0174-1551 |
| ispartof | Cardiovascular and interventional radiology, 2020-08, Vol.43 (8), p.1134-1142 |
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| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7369259 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Aged Arterial Interventions Arterial Occlusive Diseases - diagnostic imaging Arterial Occlusive Diseases - epidemiology Arterial Occlusive Diseases - pathology Arteriosclerosis Atherosclerosis Calcification Cardiology Carotid arteries Carotid artery Carotid Artery, Common - diagnostic imaging Carotid Artery, Common - pathology Carotid Artery, Common - surgery Clinical Investigation Constriction, Pathologic Diagnostic Imaging - methods Elongation Female Follow-Up Studies Humans Hyperlipidemia Imaging Implants Kaplan-Meier Estimate Male Medicine Medicine & Public Health Middle Aged Nuclear Medicine Occlusion Radiology Rank tests Recurrence Restenosis Retrospective Studies Risk analysis Risk Assessment Risk Factors Stenosis Stents Treatment Outcome Ultrasound Vascular Patency |
| title | Middle and Distal Common Carotid Artery Stenting: Long-Term Patency Rates and Risk Factors for In-Stent Restenosis |
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