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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
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Complications and outcomes of carotid artery stenting in high-risk cases

So Ozaki1, Taisuke Akimoto2, Yu Iida3

  • 1Department of Neurosurgery, Yokohama City University Medical Center, 4-57 Urafune, Minami, Yokohama 2320024, Japan.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|September 1, 2023
PubMed

Insights

Triple antithrombotic therapy increases complications in carotid artery stenting (CAS). Waiting over 28 days post-stroke for CAS may negatively impact prognosis, suggesting a potential risk in delayed treatment for high-risk patients.

Area of Science:

  • Interventional Neurology
  • Vascular Surgery
  • Stroke Medicine

Background:

  • Carotid artery stenting (CAS) is an option for select high-risk patients.
  • Optimal timing for CAS after stroke onset remains debated, particularly for high-risk individuals.

Purpose of the Study:

  • To identify factors influencing complications and outcomes in high-risk patients undergoing CAS.
  • To analyze the impact of treatment timing relative to stroke onset on CAS outcomes.

Main Methods:

  • Retrospective analysis of 152 patients treated with CAS (Jan 2018-Mar 2022).
  • Evaluation of risk factors including patient background, procedural risks (tortuosity, calcification, plaque), stenosis characteristics, and treatment timing.
  • Multivariate analysis to determine independent predictors of complications and poor outcomes (modified-Rankin Scale deterioration).

Main Results:

  • 70.4% of patients had CAS risk factors; 30.0% experienced symptomatic complications.
  • 14.0% of high-risk patients had a 90-day modified Rankin Scale score deterioration.
  • Triple antithrombotic therapy, stenting within 7 days, and stenting after 28 days post-stroke were independently associated with complications.

Conclusions:

  • Triple antithrombotic therapy is a significant risk factor for perioperative complications in CAS.
  • Delayed CAS (after 28 days) may adversely affect prognosis.
  • Waiting over one month for CAS in stroke patients could pose a risk, warranting further investigation.
Abstract

Keywords:
Antithrombotic drugsCarotid artery stentingCarotid endarterectomyRisk factor

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