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Background and Purpose — Ambulatory procedures increase patient comfort and enhance cost-effectiveness. We sought to determine the feasibility and safety of ambulatory carotid stenting. Methods — A selected group of patients was admitted and discharged the same day after the carotid stenting procedure. Immediate and short-term outcomes are reported. Results — A total of 98 ambulatory carotid stenting procedures (98 hemispheres in 92 patients) were performed. There were 66 men (72%), and the mean age was 70±9 years. Of the patients, 28% had neurological symptoms related to the treated artery within 3 months before the procedure. Sixteen percent of the patients had prior carotid endarterectomy, 4% had prior ipsilateral neck radiation, and 8% had complete occlusion of the contralateral internal carotid artery. Successful access site hemostasis was ensured in all patients with suture-mediated vascular closure devices in 96 (98%) and manual compression in 2. Clinical follow-up was available for 96% of the patients at a mean time of 6±4 months. There were no neurological events, deaths, repeated procedures, or major access site complications. Conclusions — Ambulatory carotid stenting is both safe and feasible. This approach will enhance the applicability of the procedure by increasing patient comfort and potentially reducing procedural costs.

Background and Purpose Endarterectomy for recurrent carotid stenosis after endarterectomy has a significantly higher complication rate than the original operation. Angioplasty and stenting may offer a useful alternative treatment for these patients. Methods Between September 1994 and April 1996, 22 patients had 25 carotid arteries treated with angioplasty and stenting for postendarterectomy restenosis. All patients had an independent neurological examination and National Institutes of Health Stroke Scale evaluation before and after the procedure. Patients were treated with aspirin and ticlopidine. All patients were requested to return at 6 months for follow-up angiography. The mean patient age was 69±7 years, and the mean elapsed time from endarterectomy was 73±69 months. Seventy-seven percent of the patients were symptomatic. Results Mean stenosis was reduced from 79±13% before the procedure to 1.8±3.6% after stenting. One patient had a minor stroke, for a complication rate of 4% per treated artery. In the eight patients who returned for 6-month angiography, mean stenosis was 19.4±4.4% and restenosis (≥50% stenosis) did not occur. Conclusions In a small series, angioplasty and stenting appear to be safe and well tolerated for the treatment of postendarterectomy restenosis.

P202 Background: Ambulatory procedures have been shown to increase patient’s comfort and cost-efficacy. We sought to determine the feasibility of ambulatory carotid stenting in a series of patients undergoing the procedure. Methods: Patients were electively admitted and discharged the same-day if they had successful uncomplicated carotid stenting and had demonstrated complete vascular access site hemostasis following ambulation 4–6 hours after the procedure. Patients were followed for neurological events and vascular access site complications. Results: A total of 76 same-day carotid stenting procedures were performed on 73 patients (76 arteries). There were 53 (73 %) males and the mean age was 70 ± 8 years. Seventy-nine percent of the patients were asymptomatic on presentation. Fourteen patients (18 %) had prior ipsilateral CEA, 3 (4%) had prior ipsilateral neck radiation and 6 (8 %) had contralateral occlusions. Successful access site hemostasis was achieved in all patients, using suture-mediated vascular sealing devices in 75 cases (99%). In one case hemostasis was achieved manually after failure of the sealing device. Late follow-up currently available on 62 (98%) patients at a mean of 4 ± 3 months. There have been no neurological events, deaths, repeat procedures or significant access site complications. One patient developed serous discharge from the access site at 6 weeks without evidence of infection or hematoma and was managed conservatively without complications. Conclusion: Ambulatory carotid stenting is feasible and safe. This approach will foster the applicability of the procedure by increasing patient s comfort and potentially reducing procedural costs.