The Use of Embolic Protection Devices Is Associated With a Lower Stroke and Death Rate After Carotid Stenting

Knappich, Christoph; Kuehnl, Andreas; Tsantilas, Pavlos; Schmid, Sofie; Breitkreuz, Thorben; Kallmayer, Michael; Zimmermann, Alexander; Eckstein, Hans‐Henning

doi:10.1016/j.jcin.2017.03.032

Cited by 46 publications

(32 citation statements)

References 34 publications

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“…Controlled remote access to individual patient data was granted to our group, but we have also never had direct access to microdata. Furthermore, all applied analytic methods are described in the methods section and have been described elsewhere as well …”

Section: Methodsmentioning

confidence: 99%

“…Between 2009 and 2015 the aQua Institute was commissioned and authorized by the German Federal Joint Committee (legal basis §91 German Social Security Code part 5, SGB V) to develop and implement external quality assurance in the German healthcare system pursuant to §137a SGB V. The aQua Institute was also mandated for data validation, data analysis, and publication of annual quality reports…”

Section: Methodsmentioning

confidence: 99%

“…No information on the time interval was available for 9 patients, who were therefore also excluded (N=4717). Inclusion and exclusion criteria are provided in Figure …”

Section: Methodsmentioning

confidence: 99%

“…The R extension packages gmodels , lme4 , and gam were used to calculate cross‐classified tables, chi‐squared tests, and multivariable regression analyses. The significance level for all statistical tests was set to α=0.05 …”

Section: Methodsmentioning

confidence: 99%

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Risk of Stroke or Death Is Associated With the Timing of Carotid Artery Stenting for Symptomatic Carotid Stenosis: A Secondary Data Analysis of the German Statutory Quality Assurance Database

Tsantilas

Kuehnl

Kallmayer

et al. 2018

JAHA

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BackgroundSubgroup analyses from randomized trials indicate that the time interval between the neurologic index event and carotid artery stenting is associated with periprocedural stroke and death rates in patients with symptomatic carotid stenosis. The aim of this article is to analyze whether this observation holds true under routine conditions in Germany.Methods and ResultsSecondary data analysis was done on 4717 elective carotid artery stenting procedures that were performed for symptomatic carotid stenosis. The patient cohort was divided into 4 groups according to the time interval between the index event and intervention (group I 0‐2, II 3‐7, III 8‐14, and IV 15‐180 days). Primary outcome was any in‐hospital stroke or death. For risk‐adjusted analyses, a multilevel multivariable regression model was used. The in‐hospital stroke or death rate was 3.7% in total and 6.0%, 4.4%, 2.4%, and 3.0% in groups I, II, III, and IV, respectively. Adjusted analysis showed a decreased risk for any stroke or death in group III, a decreased risk for any major stroke or death in groups III and IV, and a decreased risk for any death in groups II and III compared to the reference group I.ConclusionsA short time interval between the neurologic index event and carotid artery stenting of up to 7 days is associated with an increased risk for stroke or death under routine conditions in Germany. Although results cannot prove causal relationships, carotid artery stenting may be accompanied by an increased risk of stroke or death during the early period after the index event.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…No information on the time interval was available for 9 patients, who were therefore also excluded (N=4717). Inclusion and exclusion criteria are provided in Figure …”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Risk of Stroke or Death Is Associated With the Timing of Carotid Artery Stenting for Symptomatic Carotid Stenosis: A Secondary Data Analysis of the German Statutory Quality Assurance Database

Tsantilas

Kuehnl

Kallmayer

et al. 2018

JAHA

Self Cite

View full text Add to dashboard Cite

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“…Furthermore, all applied analytic methods are described in the methods section and have been described elsewhere as well. [8][9][10][11][12] Legal Basis of Data Acquisition Between 2009 and 2015 the aQua Institute was commissioned and authorized by the German Federal Joint Committee (legal basis §91 German Social Security Code part 5, SGB V 11 ) to develop and implement external quality assurance in the German healthcare system pursuant to §137a SGB V. The aQua Institute was also mandated for data validation, data analysis, and publication of annual quality reports. 13 In accordance with the German Federal Joint Committee directive concerning measures of transsectoral and inpatient quality assurance, 14,15 reporting of quality assurance data is compulsory for all reconstructive procedures on the extracranial carotid bifurcation.…”

Section: Methodsmentioning

confidence: 99%

Risk of Stroke or Death Is Associated With the Timing of Carotid Artery Stenting for Symptomatic Carotid Stenosis: A Secondary Data Analysis of the German Statutory Quality Assurance Database

Tsantilas¹,

Kuehnl²,

Kallmayer³

et al. 2018

Journal of Vascular Surgery

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Background--Subgroup analyses from randomized trials indicate that the time interval between the neurologic index event and carotid artery stenting is associated with periprocedural stroke and death rates in patients with symptomatic carotid stenosis. The aim of this article is to analyze whether this observation holds true under routine conditions in Germany.Methods and Results--Secondary data analysis was done on 4717 elective carotid artery stenting procedures that were performed for symptomatic carotid stenosis. The patient cohort was divided into 4 groups according to the time interval between the index event and intervention (group I 0-2, II 3-7, III 8-14, and IV 15-180 days). Primary outcome was any in-hospital stroke or death. For risk-adjusted analyses, a multilevel multivariable regression model was used. The in-hospital stroke or death rate was 3.7% in total and 6.0%, 4.4%, 2.4%, and 3.0% in groups I, II, III, and IV, respectively. Adjusted analysis showed a decreased risk for any stroke or death in group III, a decreased risk for any major stroke or death in groups III and IV, and a decreased risk for any death in groups II and III compared to the reference group I.Conclusions--A short time interval between the neurologic index event and carotid artery stenting of up to 7 days is associated with an increased risk for stroke or death under routine conditions in Germany. Although results cannot prove causal relationships, carotid artery stenting may be accompanied by an increased risk of stroke or death during the early period after the index event. ( J Am Heart Assoc. 2018;7:e007983.

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Extrakranielle Karotisstenose

Debus¹,

Grundmann²

2018

Evidenzbasierte Chirurgie

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The Use of Embolic Protection Devices Is Associated With a Lower Stroke and Death Rate After Carotid Stenting

Abstract: The use of an embolic protection device was independently associated with lower in-hospital risk for stroke or death, major stroke or death, and stroke.

Cited by 46 publications

References 34 publications

Risk of Stroke or Death Is Associated With the Timing of Carotid Artery Stenting for Symptomatic Carotid Stenosis: A Secondary Data Analysis of the German Statutory Quality Assurance Database

Risk of Stroke or Death Is Associated With the Timing of Carotid Artery Stenting for Symptomatic Carotid Stenosis: A Secondary Data Analysis of the German Statutory Quality Assurance Database

Risk of Stroke or Death Is Associated With the Timing of Carotid Artery Stenting for Symptomatic Carotid Stenosis: A Secondary Data Analysis of the German Statutory Quality Assurance Database

Extrakranielle Karotisstenose

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