The role of endovascular expertise in carotid artery stenting: results from the ALKK-CAS-Registry in 5,535 patients
| Autor: | Ralf Zahn, Matthias Hochadel, Manuela Segerer, Andre Schneider, Thomas Fürste, Stephan Staubach, Christian Gottkehaskamp, Harald Mudra, Ralph Hein-Rothweiler, Gotthard Rieß, Hubert Seggewiß, Jens Jung |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Carotid arteries Embolic Protection Devices Risk Factors Internal medicine Germany medicine Odds Ratio Humans Carotid Stenosis Hospital Mortality Prospective Studies Registries Stroke Embolic protection Aged business.industry Endovascular Procedures General Medicine medicine.disease Surgery Stenosis Logistic Models Treatment Outcome Education Medical Graduate Cohort Cardiology Female Stents Clinical Competence Cardiology and Cardiovascular Medicine business Learning Curve |
| Zdroj: | Clinical research in cardiology : official journal of the German Cardiac Society. 101(11) |
| ISSN: | 1861-0692 |
| Popis: | Several scientific committees have proposed an accentuation of operator minimal requirements before accreditation for carotid artery stenting is granted. The current study aims to identify potential effects from increasing site experience on periprocedural safety and outcome of carotid artery stenting (CAS). Between 1996 and December 2009, 5,535 procedures have been entered into the prospective, controlled ALKK-CAS-Registry. The total cohort was divided in four subgroups according to the consecutive patient order at each participating center: patients 1–49 (n = 1,485), 50–99 (n = 1,118), 100–199 (n = 1,521) and ≥200 (n = 1,411). The median age of all patients was 71 years; 52.8 % had a symptomatic carotid stenosis. A decline in the rates of in-hospital major stroke (2.1, 1.9, 1.6, 0.9, p for trend 0.014) and of ipsilateral strokes (3.1, 2.4, 2.5, 1.6 %, p for trend 0.019) was substantiated with increasing site experience. This significant trend was preserved in the combined rate of major stroke and death (4.0, 3.2, 3.4, 2.4 %, p for trend 0.034). Apart from CAS experience, improvements in CAS technique, a decreasing number of symptomatic patients and an increasing number of procedures under embolic protection (each p for trend |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink