Complications and outcomes of carotid artery stenting in high-risk cases
Copyright © 2023 Elsevier Inc. All rights reserved..
OBJECTIVES: Carotid artery stenting is sometimes adapted for some at-risk cases; however, appropriate treatment timing with stroke onset is controversial. This study aims to identify factors that have an impact on complications and outcomes, especially in patients at high risk.
MATERIALS AND METHODS: We examined the characteristics of 152 consecutive patients treated by carotid artery stenting between January 2018 and March 2022 and retrospectively analyzed the risk factors for complications and poor outcomes (modified-Rankin-Scale deterioration), such as patient background, carotid artery stenting risks (access route tortuosity, severe calcification, vulnerable plaque, estimated glomerular filtration rate <30 mL/min/1.73 m2, etc.), characteristics of the stenosis, details of treatment, and treatment timing.
RESULTS: The average North American Symptomatic Carotid Endarterectomy Trial criteria score was 68.3% and the lesion length was 20.5±9.7mm. Among patients, 107 (70.4%) had a carotid artery stenting risk. In high-risk carotid artery stenting cases, symptomatic complications occurred in 32 (30.0%), and the 90-day modified Rankin scale score deteriorated in 15 cases (14.0%). Multivariate analysis showed that cases with triple antithrombotic therapy (p=0.003), stenting within 7 days (p=0.0032), and after 28+ days (p=0.0035) of stroke onset were independently associated factors for complications.
CONCLUSIONS: This study showed that among risk factors, triple antithrombotic therapy in particular was a risk factor for perioperative complications. Carotid artery stenting for patients with stroke after 28 days of onset affects the prognosis. Therefore, although further study is warranted, waiting more than one month for treatment in patients requiring carotid artery stenting is a potential risk.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:32 |
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| Enthalten in: |
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association - 32(2023), 10 vom: 01. Okt., Seite 107329 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ozaki, So [VerfasserIn] |
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| Links: |
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| Themen: |
Antithrombotic drugs |
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| Anmerkungen: |
Date Completed 25.09.2023 Date Revised 25.09.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jstrokecerebrovasdis.2023.107329 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM361551665 |
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| 245 | 1 | 0 | |a Complications and outcomes of carotid artery stenting in high-risk cases |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVES: Carotid artery stenting is sometimes adapted for some at-risk cases; however, appropriate treatment timing with stroke onset is controversial. This study aims to identify factors that have an impact on complications and outcomes, especially in patients at high risk | ||
| 520 | |a MATERIALS AND METHODS: We examined the characteristics of 152 consecutive patients treated by carotid artery stenting between January 2018 and March 2022 and retrospectively analyzed the risk factors for complications and poor outcomes (modified-Rankin-Scale deterioration), such as patient background, carotid artery stenting risks (access route tortuosity, severe calcification, vulnerable plaque, estimated glomerular filtration rate <30 mL/min/1.73 m2, etc.), characteristics of the stenosis, details of treatment, and treatment timing | ||
| 520 | |a RESULTS: The average North American Symptomatic Carotid Endarterectomy Trial criteria score was 68.3% and the lesion length was 20.5±9.7mm. Among patients, 107 (70.4%) had a carotid artery stenting risk. In high-risk carotid artery stenting cases, symptomatic complications occurred in 32 (30.0%), and the 90-day modified Rankin scale score deteriorated in 15 cases (14.0%). Multivariate analysis showed that cases with triple antithrombotic therapy (p=0.003), stenting within 7 days (p=0.0032), and after 28+ days (p=0.0035) of stroke onset were independently associated factors for complications | ||
| 520 | |a CONCLUSIONS: This study showed that among risk factors, triple antithrombotic therapy in particular was a risk factor for perioperative complications. Carotid artery stenting for patients with stroke after 28 days of onset affects the prognosis. Therefore, although further study is warranted, waiting more than one month for treatment in patients requiring carotid artery stenting is a potential risk | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Antithrombotic drugs | |
| 650 | 4 | |a Carotid artery stenting | |
| 650 | 4 | |a Carotid endarterectomy | |
| 650 | 4 | |a Risk factor | |
| 650 | 7 | |a Fibrinolytic Agents |2 NLM | |
| 700 | 1 | |a Akimoto, Taisuke |e verfasserin |4 aut | |
| 700 | 1 | |a Iida, Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Miyake, Shigeta |e verfasserin |4 aut | |
| 700 | 1 | |a Suzuki, Ryosuke |e verfasserin |4 aut | |
| 700 | 1 | |a Shimohigoshi, Wataru |e verfasserin |4 aut | |
| 700 | 1 | |a Hori, Satoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Suenaga, Jun |e verfasserin |4 aut | |
| 700 | 1 | |a Shimizu, Nobuyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Nakai, Yasunobu |e verfasserin |4 aut | |
| 700 | 1 | |a Sakata, Katsumi |e verfasserin |4 aut | |
| 700 | 1 | |a Yamamoto, Tetsuya |e verfasserin |4 aut | |
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