The incidence and risk factors of stent fracture in patients treated for proximal common carotid artery stenosis

Vértes, Miklós; Nguyen, Dat Tin; Székely, György; Bérczi, Ákos; Dósa, Edit

doi:10.1016/j.jvs.2019.04.492

Cited by 5 publications

(11 citation statements)

References 23 publications

(33 reference statements)

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Section: Discussionmentioning

confidence: 99%

“…The technical success rate of percutaneous antegrade stenting of proximal CCA ranges between 95 and 100% [ 8 – 14 ]. Access site complications were observed in less than 6% of patients [ 8 – 14 ]. So far, only one procedure-related death was reported; this was due to retroperitoneal bleeding [ 8 – 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Access site complications were observed in less than 6% of patients [ 8 – 14 ]. So far, only one procedure-related death was reported; this was due to retroperitoneal bleeding [ 8 – 14 ]. Transient ischemic attack occurred in 0–5.9% (ipsilateral, 0–2%), ipsilateral minor stroke in 0–4.7%, ipsilateral major stroke in 0–2%, and myocardial infarction in 0–1.5% within 30 days following antegrade stenting of the proximal CCA [ 8 – 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Diagnosis of middle/distal CCA stenosis was established with duplex ultrasonography (DUS), computed tomography angiography (CTA), or magnetic resonance angiography, and was verified with digital subtraction angiography (DSA) during the procedure. The preprocedural workup and stenting protocol have been described previously [ 14 ]. The indication for intervention was the presence of either asymptomatic but ≥ 70% luminal narrowing ( N = 23 [45.1%]) or symptomatic and ≥ 60% stenosis ( N = 28 [54.9%]).…”

Section: Methodsmentioning

confidence: 99%

“…We were unable to identify publications on the long-term patency of middle/distal CCA stenting and the risk factors for in-stent restenosis (ISR). Most studies focused on proximal CCA stenting and found low ISR rates (0–19%), with no predictors of ISR [ 8 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Middle and Distal Common Carotid Artery Stenting: Long-Term Patency Rates and Risk Factors for In-Stent Restenosis

Vértes

Nguyen

Székely

et al. 2020

Cardiovasc Intervent Radiol

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Purpose In the absence of literature data, we aimed to determine the long-term patency rates of middle/distal common carotid artery (CCA) stenting and to investigate predisposing factors in the development of in-stent restenosis (ISR). Materials and Methods Fifty-one patients (30 males, median age 63.5 years), who underwent stenting with 51 self-expandable stents for significant (≥ 60%) stenosis of the middle/distal CCA, were analyzed retrospectively. Patient (atherosclerotic risk factors, comorbidities, medications), vessel (elongation), lesion (stenosis grade, length, calcification, location), and stent characteristics (material, diameter, length, fracture) were examined. Duplex ultrasonography was used to monitor stent patency. The Mann–Whitney U and Fisher’s exact tests, Kaplan–Meier analyses, and a log-rank test were used statistically. Results The median follow-up time was 35 months (interquartile range, 20–102 months). Significant (≥ 70%) ISR developed in 14 patients (27.5%; stenosis, N = 10; entire CCA occlusion, N = 4). Primary patency rates were 98%, 92%, 83%, 73%, and 61% at 6, 12, 24, 60, and 96 months, respectively. Reintervention was performed in six patients (11.8%) with nonocclusive ISR. Secondary patency rates were 100% at 6 and 12 months and 96% at 24, 60, and 96 months. In-stent restenosis developed more frequently ( P < .001) in patients with hyperlipidemia; primary patency rates were also significantly worse (Chi-square, 11.08; degrees of freedom, 1; P < .001) in patients with hyperlipidemia compared to those without. Conclusion Stenting of the middle/distal CCA can be performed with acceptable patency rates. If intervention is unequivocally needed, patients with hyperlipidemia will require closer follow-up care. Level of Evidence Level 3, Local non-random sample.

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