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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Residual stenosis after carotid artery stenting: Effect on periprocedural and long-term outcomes
Jihoon Kang1, Jeong-Ho Hong2, Beom Joon Kim1
1Department of Neurology, Seoul National University Bundang Hospital, Seoul National University, Seongnam, Republic of Korea.
Insights
Residual stenosis after carotid artery stenting (CAS) impacts periprocedural outcomes and restenosis risk. This finding aids in predicting patient results following CAS procedures.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Neurology
Background:
- Carotid artery stenosis is a significant risk factor for stroke.
- Carotid artery stenting (CAS) is a common treatment for carotid artery stenosis.
- The impact of residual stenosis post-CAS on patient outcomes requires further investigation.
Purpose of the Study:
- To evaluate the association between residual stenosis after CAS and periprocedural outcomes.
- To assess the effect of residual stenosis on long-term restenosis and clinical outcomes.
- To determine if residual stenosis can serve as a predictive marker for CAS outcomes.
Main Methods:
- A cohort of 412 patients undergoing CAS for carotid stenosis was analyzed.
- Residual stenosis was quantified from post-procedure angiography.
- Logistic regression and Wei-Lin-Weissfeld models were used to analyze outcomes.
Main Results:
- Residual stenosis was significantly linked to periprocedural outcomes (aOR, 0.983; P = 0.01).
- Over 5 years, residual stenosis did not elevate overall restenosis or clinical event risk.
- However, residual stenosis increased the hazard for restenosis (aHR, 1.041) but not clinical outcomes.
Conclusions:
- Residual stenosis after CAS is a significant predictor of periprocedural outcomes.
- It also serves as a predictor for restenosis development post-CAS.
- These findings highlight the importance of assessing residual stenosis for patient risk stratification.
Objective:
This study investigated the effect of residual stenosis after carotid artery stenting (CAS) on periprocedural and long-term outcomes.
Methods:
Patients treated with CAS for symptomatic or asymptomatic carotid arterial stenosis were consecutively enrolled. Residual stenosis was estimated from post-procedure angiography findings. The effects of residual stenosis on 30-day periprocedural outcome and times to restenosis and clinical outcome were analyzed using logistic regression models and Wei-Lin-Weissfeld models, respectively.
Results:
A total of 412 patients (age, 64.7 ± 17.0 years; male, 82.0%) were enrolled. The median baseline stenosis was 80% (interquartile range [IQR], 70-90%), which improved to 10% (0-30%) for residual stenosis. Residual stenosis was significantly associated with periprocedural outcome (adjusted odds ratio, 0.983; 95% confidence interval [CI], 0.965-0.999, P = 0.01) after adjustment for baseline stenosis, age, hypertension, symptomaticity, and statin use. Over the 5-year observation period, residual stenosis did not increase the global hazard for restenosis and clinical outcome (adjusted hazard ratio, 1.011; 95% CI, 0.997-1.025. In the event-specific model, residual stenosis increased the hazard for restenosis (adjusted hazard ratio, 1.041; 1.012-1.072) but not for clinical outcome (adjusted hazard ratio, 1.011; 0.997-1.025).
Conclusions:
Residual stenosis after carotid artery stenting may be useful to predict periprocedural outcome and restenosis.
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