Early and mid‐term outcomes of carotid angioplasty and stent placement in 579 patients

Abstract

Background and Purpose Carotid angioplasty and stenting (CAS) could be considered for preventing stroke in patients with carotid artery stenosis. This study aimed to determine the incidence and the risk factors of the early and mid‐term complications associated with CAS. Methods This is a retrospective cohort study conducted at Shiraz University of Medical Sciences from March 2011 to March 2019. Patients at high risk and standard risk for carotid endarterectomy were included. The primary composite outcome was defined as stroke, myocardial infarction (MI), and death in the first 30 days after CAS. All‐cause mortality, vascular mortality, and stroke were investigated during mid‐term follow‐up. Results A total of 579 patients (618 CAS) were recruited (mean age: 71.52 years). Overall, 394 (68.40%), 211 (36.63%), 179 (31.07%), and 96 (16.72%) patients had hypertension, dyslipidemia, diabetes mellitus, or were cigarette smokers, respectively. Primary composite outcomes were observed in 2.59% of patients (1.55% stroke, 0.69% MI, and 1.72% death). Atrial fibrillation was a predictor of primary composite outcome in multivariate logistic regression (p = .048). The presence of total occlusion in the contralateral carotid artery was significantly associated with the risk of stroke in univariate logistic regression (p = .041). The patients were followed for a period ranging from 1 to 83 months. The overall survival rate for all‐cause mortality was 93.48% at 1 year, 77.24% at 5 years, and 52.92% at 8 years. All‐cause mortality was significantly higher among patients with symptomatic carotid stenosis (p = .014). Conclusion CAS provides acceptable short‐term and mid‐term outcomes in a unique population of high‐ and standard‐surgical‐risk, symptomatic and asymptomatic, octogenarian, and nonoctogenarian patients.

Low-Density Lipoprotein Cholesterol Levels Are Associated With Subsequent Stented-Territory Ischemic Stroke After Carotid Artery Stenting: A Single Center Retrospective Study

“… 12 13 Although a previous study has reported that dyslipidemia is a predictor of recurrent ipsilateral ischemic stroke, 14 another long-term follow-up study has shown that it cannot be considered a predictor. 15 In a study conducted in Korea, fewer ischemic strokes were observed in patients with dyslipidemia. 16 Regarding the cholesterol profile, LDL-C levels are related to new diffusion-weighted image lesions observed in the acute phase immediately after CAS.…”