scholarly journals Factors Determining Periprocedural and Long-term Complications of High Risk Carotid Artery Stenting

2015 ◽  
Vol 42 (1) ◽  
pp. 48-54
Author(s):  
Vincent Dinculescu ◽  
Anne C.M. Ritter ◽  
Marlise P. dos Santos ◽  
Ravi M. Mohan ◽  
Betty A. Schwarz ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Large Scale ◽  
High Risk Patient ◽  
Patient Characteristics ◽  
High Risk Patients ◽  
Risk Patients

ABSTRACTBackground and Purpose: Carotid artery stenting (CAS) has been, historically, an alternative to open endarterectomy (CEA) for stroke prevention in high risk patients with carotid atherosclerosis. We sought to determine the rates of periprocedural and long-term stroke or death and the risk factors for complications after CAS in our high risk patient population. Methods: Clinical and treatment variables of consecutive CAS procedures performed between 2002 and 2011 were analyzed. Using univariate and multivariate logistic regression analyses we examined how patient characteristics influenced outcomes and changes in modified Rankin Score (mRS). Results: In 152 patients, the composite total of periprocedural death, stroke, transient ischemic attack (TIA) and myocardial infarction (MI) rate was 3.95% (6/152). Chronic kidney disease (CKD) was strongly associated with periprocedural complications (p<0.001). Coronary artery disease/peripheral vascular disease (CAD/PVD) (p=0.03), dyslipidemia (p=0.02), CKD (p=0.01), and contralateral internal carotid artery stenosis (p=0.02) were non-modifiable risk factors for mRS increase. There were 25 deaths, 8 strokes, 11 TIAs, and 1 MI (mean follow-up 38.4 months, range 0-116 months). The presence of CAD/PVD (p=0.009) and dyslipidemia (p=0.002) were significantly associated with long-term complications. Conclusion: CAS was performed with low periprocedural complications in high-risk patients. Our rates compare very favorably to large-scale trials that have ideal patients. This data encourages the consideration of CAS in patients considered high risk for CEA and provides possible patient characteristics (CKD) to help with periprocedural risk stratification.

scholarly journals TCT-22 Single-Center Long-Term Experience With Carotid Artery Stenting in High-Risk Patients

2021 ◽  
Vol 78 (19) ◽  
pp. B10
Author(s):  
Rafath Ullah ◽  
Blair Tilkens ◽  
Kevin Bodker ◽  
Aashish Katapadi ◽  
Khalil Odeh ◽  
...  
Keyword(s):  
High Risk ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Single Center ◽  
High Risk Patients ◽  
Risk Patients ◽  
Long Term Experience

Carotid artery stenting with routine cerebral protection in high-risk patients

2004 ◽  
Vol 188 (6) ◽  
pp. 644-652 ◽  
Author(s):  
Peter H. Lin ◽  
Ruth L. Bush ◽  
Dieter F. Lubbe ◽  
Mitchell M. Cox ◽  
Wei Zhou ◽  
...  
Keyword(s):  
High Risk ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Cerebral Protection ◽  
High Risk Patients ◽  
Risk Patients

Outcomes of carotid artery stenting in high-risk patients; a single center retrospective review

2012 ◽  
Vol 54 (4) ◽  
pp. 289
Author(s):  
Ahmet Kirbas ◽  
Nursen Tanrikulu ◽  
Mutlu Cihangiroglu ◽  
Omer Isik
Keyword(s):  
High Risk ◽  
Carotid Artery ◽  
Retrospective Review ◽  
Carotid Artery Stenting ◽  
Single Center ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals Postoperative ischemic events in patients undergoing carotid artery stenting using algorithmic selection for embolic protection

2019 ◽  
Vol 32 (4) ◽  
pp. 294-302 ◽  
Author(s):  
Yasuhiro Kawabata ◽  
Norio Nakajima ◽  
Hidenori Miyake ◽  
Shunichi Fukuda ◽  
Tetsuya Tsukahara
Keyword(s):  
High Risk ◽  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Transient Ischemic Attack ◽  
Carotid Artery Stenting ◽  
Minor Stroke ◽  
High Risk Patients ◽  
Embolic Protection ◽  
Risk Patients ◽  
Ischemic Attack

Purpose Carotid artery stenting (CAS) is a valuable alternative to carotid endarterectomy, especially in high-risk patients. However, the reported incidences of perioperative stroke and death remain higher than for carotid endarterectomy, even when using embolic protection devices (EPDs) during CAS. Our purpose was to evaluate 30-day major adverse events after CAS when selecting the most appropriate EPD. Methods We reviewed the clinical outcomes of 61 patients with 64 lesions who underwent CAS with EPDs. Patients who underwent CAS associated with thrombectomy and who had a preoperative modified Rankin scale score >3 were excluded from the analysis. The EPD was selected based on symptoms, carotid wall magnetic resonance imaging and lesion length, and we analyzed combined 30-day complication rates (transient ischemic attack, minor stroke, major stroke or death). Results Forty-nine patients were men and 12 were women. The median age was 72 years (range: 59–89 years) and 44 lesions were asymptomatic. A filter-type EPD was selected in 23 procedures, distal-balloon protection in 14 procedures and proximal-occlusive protection in 27 procedures. Two patients (3.1%) experienced a transient ischemic attack and one patient (1.6%) had a minor stroke within 30 days of the procedure. No patients experienced procedure-related morbidities (modified Rankin score >2) or death. Conclusions The perioperative stoke rate was low when we selected a proximal-occlusive-type EPD in high-risk patients with vulnerable carotid artery disease. Our algorithm for EPD selection was an effective tool in the perioperative management of carotid artery stenosis.

scholarly journals Cerebral microembolization after protected carotid artery stenting in surgical high-risk patients: Results of a 2-year prospective study

2005 ◽  
Vol 42 (5) ◽  
pp. 847-853 ◽  
Author(s):  
Frank D. Hammer ◽  
Valerie Lacroix ◽  
Thierry Duprez ◽  
Cecile Grandin ◽  
Robert Verhelst ◽  
...  
Keyword(s):  
High Risk ◽  
Carotid Artery ◽  
Prospective Study ◽  
Carotid Artery Stenting ◽  
High Risk Patients ◽  
Risk Patients
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