Emergent treatment of carotid stenosis: an evidence-based systematic review

Serra, Raffaele; Barbetta, Andrea; Fugetto, Francesco; Licastro, Noemi; Aprea, Giovanni; Petrella, Giuseppe; Danzi, Michele; Rocca, Aldo; Compagna, Rita; Franciscis, Stefano de; Amato, Bruno

doi:10.23736/s0026-4733.18.07767-2

Cited by 1 publication

(1 citation statement)

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“…Carotid artery endarterectomy (CEA) and carotid artery stenting (CAS) are two common treatments for carotid artery stenosis. Compared to CEA, CAS is minimally invasive, so the latter is accepted as an alternative to CEA, especially among those with high surgical risk [6,7]. However, growing evidence have demonstrated that CAS treatment is related to high risk of stroke, restenosis, mortality, as well as perioperative complications, like contrast-induced nephropathy (CIN) [8][9][10][11].…”

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confidence: 99%

Clinical efficacy and safety of statin treatment after carotid artery stenting

Qiao

Wang

Jia

et al. 2019

Artificial Cells, Nanomedicine, and Biotechnology

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Objective: The randomized controlled trail was carried out to investigate the influence of statin pretreatment on clinical efficacy of carotid artery stenting (CAS). Methods: 160 eligible patients were randomly divided into statin group (n ¼ 82) and control group (n ¼ 78). The patients in statin group received 40 mg atorvastatin daily 7 days before operation. Major endpoints included transient ischemic attack (TIA), stroke, death, myocardial infarction (MI), and other cardiac adverse events within 30 days after CAS. Results: Preoperative baseline information was similar between the statin and control groups (p > 0.05 for all). Within 48 h after operation, the occurrence rate of CIN (3.66% vs 8.97%, p ¼ .019) and new infarction (4.88% vs. 14.10%, p ¼ .045) were significantly lower in statin group than in control group. 30 days after CAS, the incidences of TIA (12.20% vs. 26.92%, p ¼ .018), ischemic stroke (6.10% vs. 16.67%, p ¼ .034), and other cardiac complications (7.32% vs. 19.23%, p ¼ .026) were also significantly lower in statin group, than in the control group. Multiple analysis demonstrated that statin use exerted protective effect against ischemic stroke (OR ¼ 0.038, 95% CI ¼ 0.003-0.543, p ¼ .016) and other cardiac complications (OR ¼ 0.208, 95%CI ¼ 0.063-0.694, p ¼ .011). Conclusion: Pre-treatment with statin is an effective and safe strategy to prevent from perioperative complications and to improve postoperative outcomes in patients undergoing CAS. ARTICLE HISTORY

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