Are there predictive risk factors for complications after carotid artery stenting?
M Bosiers1, G De Donato, K Deloose
1Department of Vascular Surgery, AZ St-Blasius, Dendermonde, Belgium. marc.bosiers@telenet.be
Insights
Carotid artery stenting (CAS) is safe. Preprocedural neurological symptoms and hypercholesterolemia increase the risk of 30-day neurological complications following CAS.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Neurology
Background:
- Carotid artery stenting (CAS) is a common procedure for preventing stroke.
- Identifying risk factors for CAS complications is crucial for patient safety.
Purpose of the Study:
- To identify predictive risk factors for neurological complications during and after CAS.
- To analyze risk factor distribution in patients with and without 30-day neurological complications post-CAS.
Main Methods:
- Multivariate analysis of data from 4 European high-volume centers.
- Examined 3,179 consecutive CAS procedures.
- Assessed risk factors including age, symptoms, gender, and comorbidities.
Main Results:
- The overall 30-day neurological complication rate was 2.8%.
- Symptomatic patients and those with hypercholesterolemia had a significantly increased risk (P=0.02).
- Asymptomatic patients without hypercholesterolemia demonstrated the lowest risk.
Conclusions:
- CAS is a safe procedure when performed by experienced practitioners.
- Preprocedural neurological complaints and hypercholesterolemia are significant predisposing factors for 30-day neurological complications.
Aim:
The aim of this study was to identify predictive risk factors for complications during and after carotid artery stenting (CAS).
Methods:
A multivariate analysis was performed on the databases of 4 European high-volume centers regarding risk factor distribution between patients presenting with or without neurological complications 30 days after CAS. The cumulative 30-day neurological complication rate (death, major stroke, minor stroke and transient ischemic attack) was 2.8% in the total examined cohort of 3 179 consecutive CAS procedures. The following risk factors were taken into consideration for statistical analysis: age, symptomatic, male gender, nicotine abuse, hypertension, hypercholesterolemia, polyvascular disease, diabetes, restenosis after carotid endarterectomy (CEA)/CAS, calcified internal carotid artery.
Results:
Symptomatic (P=0.02) or hypercholesterolemic (P=0.02) patients are at significantly increased risk for neurological events 30 days after CAS. Asymptomatic women and men without hypercholesterolemia have the lowest risk on any 30-day neurological complications after CAS.
Conclusions:
CAS is a safe technique in experienced hands. Preprocedural neurological complaints and hypercholesterolemia can be defined as predisposing factors for 30-day neurological complications after CAS.
Related Concept Videos
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01:15Ischemic Stroke l: Introduction
01:28Cardiac Catheterization I: Pre-Procedure Overview