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Risk Factors for Hemodynamic Depression After Carotid Stenting
Yaoliang Wang1, Wei Liu1, Yile Zhang1
1Department of Neurosurgery, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, China.
World Neurosurgery
|February 15, 2025
Summary
Tapered stents (TS) significantly reduce hemodynamic depression (HD) after carotid artery stenting compared to straight stents. TS also showed a trend toward lower 1-year in-stent restenosis (ISR), suggesting improved outcomes.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Biomedical Engineering
Background:
- Carotid artery stenting (CAS) is a common procedure to treat carotid artery stenosis.
- The impact of stent design and stenosis morphology on post-procedural hemodynamic depression (HD) and in-stent restenosis (ISR) remains incompletely understood.
Purpose of the Study:
- To investigate the influence of tapered stents (TS) versus straight stents on HD and ISR after CAS.
- To identify risk factors associated with HD based on stent type and stenosis morphology.
Main Methods:
- Retrospective analysis of 142 patients undergoing CAS.
- Stratification of patients based on stent type (straight vs. TS) and stenosis morphology (centripetal vs. eccentric).
- Logistic regression analysis to determine risk factors for HD.
Main Results:
- TS demonstrated a significantly lower incidence of postprocedural HD (38.8% vs. 60.0%) and a trend towards lower 1-year ISR (1.5% vs. 8.0%) compared to straight stents.
- In eccentric stenosis, TS significantly reduced postprocedural HD (42.2% vs. 67.3%).
- Risk factors for HD included eccentric stenosis, high-echo plaque, open-cell stent design, and distal stent diameter.
Conclusions:
- Tapered stents are associated with reduced risk of postoperative HD and a trend towards lower ISR after CAS.
- Eccentric stenosis, high-echo plaque, open-cell stent design, and distal stent diameter are identified as significant risk factors for HD.
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