Carotid Artery Stenting in Patients with Symptomatic and Asymptomatic Stenosis: In-Hospital Clinical Outcomes at a Single Neurovascular Center.

Autor: Hajiyev K; Neuroradiologische Klinik, Klinikum Stuttgart, D-70174 Stuttgart, Germany., Hellstern V; Neuroradiologische Klinik, Klinikum Stuttgart, D-70174 Stuttgart, Germany., Cimpoca A; Neuroradiologische Klinik, Klinikum Stuttgart, D-70174 Stuttgart, Germany., Wendl C; Institut für Röntgendiagnostik, Zentrum für Neuroradiologie, Fakultät für Medizin, Universität Regensburg, D-93053 Regensburg, Germany., Bäzner H; Neurologische Klinik, Klinikum Stuttgart, D-70174 Stuttgart, Germany., Henkes H; Neuroradiologische Klinik, Klinikum Stuttgart, D-70174 Stuttgart, Germany.; Medizinische Fakultät, University Duisburg-Essen, D-47057 Duisburg, Germany., von Gottberg P; Neuroradiologische Klinik, Klinikum Stuttgart, D-70174 Stuttgart, Germany.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2022 Apr 07; Vol. 11 (8). Date of Electronic Publication: 2022 Apr 07.
DOI: 10.3390/jcm11082086
Abstrakt: Background: Carotid artery stenting (CAS) is a minimally invasive and proven percutaneous procedure that is widely used to treat patients with symptomatic and asymptomatic carotid artery stenosis. The purpose of this study was to characterize the in-hospital outcomes of symptomatic and asymptomatic patients undergoing CAS at a single neurovascular center.
Methods: The study was conducted as a retrospective analysis of 1158 patients (asymptomatic, n = 636; symptomatic, n = 522; male, n = 816; median age, 71 years; NASCET method, 70-99% stenosis, n = 830) who underwent CAS between May 2009 and December 2020. In-hospital neurological outcomes, adverse reactions to iodinated contrast media, acute myocardial infarction, intraprocedural complications, and access-site issues were evaluated. The primary endpoints were disabling stroke (including disabling cerebral hyperperfusion syndrome [CHS]) and all in-hospital deaths.
Results: A carotid stent could not be deployed in one patient due to calcified plaques (technical failure rate of 0.09%). Four patients (0.3%) experienced in-hospital, stroke-associated death, while five patients (0.4%) died from non-stroke-related causes. All stroke-associated deaths occurred in the symptomatic group and were due to CHS. The disabling stroke rate was 0.9% overall ( n = 10; 0.5% versus 1.3% in asymptomatic versus symptomatic patients, respectively). Nineteen patients (1.6%) reached the in-hospital primary endpoint. More patients in the symptomatic group achieved this endpoint than in the asymptomatic group (2.5% versus 0.9%, respectively; p = 0.060).
Conclusions: An evaluation was conducted on the in-hospital outcomes of 1158 patients at a single center who underwent CAS and was performed by trained physicians who were supervised by a senior neurovascular interventionist with over 20 years of experience, confirming the excellent safety profile of this procedure with a low rate of complications.
Databáze: MEDLINE
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