Afshin Borhani Haghighi1, Samaneh Yousefi2, Ehsan Bahramali3, Safoora Kokabi4, Seyed Taghi Heydari5, Abdolhamid Shariat1, Alireza Nikseresht1, Nahid Ashjazadeh1, Sadegh Izadi1, Peyman Petramfar1, Maryam Poursadegh1, Abbas Rahimi Jaberi1, Sajjad Emami6, Hamid Agheli7, Reza Nemati8, Ehsan Yaghoubi9, Mohammad Hosein Abdi10, Majid Panahandeh11, Moslem Heydari12, Anahid Safari13, Marziyeh Basir14, Salvador Cruz-Flores15, Randal Edgell16. 1. Clinical Neurology Research Center, Shiraz University of Medical Sciences, Fasa, Iran ; Department of Neurology, Shiraz University of Medical Sciences, Fasa, Iran. 2. Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran. 3. Cardiology Department, Faculty of Medicine, Fasa University of Medical Sciences, Fasa, Iran. 4. Transgenic Technology Research Center, Shiraz University of Medical Sciences, Fasa, Iran. 5. Health Policy Research Center, Shiraz University of Medical Sciences, Fasa, Iran. 6. Department of Neurology, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran. 7. Shahidzadeh Hospital, Behbahan, Bushehr University of Medical Sciences, Bushehr, Iran. 8. Department of Neurology, Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran. 9. Department of Neurology, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran. 10. Motaharri Hospital, Marvdasht, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. 11. Ordibehesht Hospital, Shiraz, Fasa University of Medical Sciences, Fasa, Iran. 12. Department of Neurology, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. 13. Department of Pharmacology, Kazeroon Azad University, Kazeroon, Iran. 14. Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran. 15. Department of Neurology, Texas Tech University, El Paso, Tex., USA. 16. Department of Neurology, Saint Louis University, Saint Louis, Mo., USA ; Department of Psychiatry, Saint Louis University, Saint Louis, Mo., USA.
Abstract
BACKGROUND: Carotid angioplasty and stenting (CAS) is an accepted treatment to prevent stroke in patients with carotid artery stenosis. The purpose of this study is to identify risk factors for major complications after CAS. MATERIALS AND METHODS: This is a prospective study that was conducted at Shiraz University of Medical Sciences in southern Iran from March 2011 to June 2014. Consecutive patients undergoing CAS were enrolled. Both standard- and high-risk patients for endarterectomy were enrolled. Demographic data, atherosclerotic risk factors, site of stenosis, degree of stenosis, and data regarding technical factors were recorded. Thirty-day stroke, myocardial infarction, and/or death were considered as the composite primary outcomes of the study. RESULTS: A total of 251 patients were recruited (mean age: 71.1 ± 9.6 years; male: 65.3%). Of these, 178 (70.9%) were symptomatic, 73 (29.1%) were diabetic, 129 (51.4%) were hyperlipidemic, 165 (65.7%) were hypertensive, and 62 (24.7%) patients were smokers. CAS was performed for left internal carotid artery (ICA) in 113 (45.4%) patients. Fourteen (5.6%) patients had sequential bilateral stenting. Mean stenosis of operated ICA was 80.2 ± 13.8%. An embolic protection device was used in 203 (96.2%) patients. Pre- and postdilation were performed in 39 (18.5%) and 182 (86.3%) patients, respectively. Composite outcomes were observed in 3.6% of patients (3.2% stroke, 0% myocardial infarction, and 1.2% death). Left-sided lesions and the presence of diabetes mellitus were significantly associated with poor short-term outcome (p = 0.025 and p = 0.020, respectively). CONCLUSION: There was a higher risk of short-term major complications in diabetic patients and for left carotid artery intervention.
BACKGROUND: Carotid angioplasty and stenting (CAS) is an accepted treatment to prevent stroke in patients with carotid artery stenosis. The purpose of this study is to identify risk factors for major complications after CAS. MATERIALS AND METHODS: This is a prospective study that was conducted at Shiraz University of Medical Sciences in southern Iran from March 2011 to June 2014. Consecutive patients undergoing CAS were enrolled. Both standard- and high-risk patients for endarterectomy were enrolled. Demographic data, atherosclerotic risk factors, site of stenosis, degree of stenosis, and data regarding technical factors were recorded. Thirty-day stroke, myocardial infarction, and/or death were considered as the composite primary outcomes of the study. RESULTS: A total of 251 patients were recruited (mean age: 71.1 ± 9.6 years; male: 65.3%). Of these, 178 (70.9%) were symptomatic, 73 (29.1%) were diabetic, 129 (51.4%) were hyperlipidemic, 165 (65.7%) were hypertensive, and 62 (24.7%) patients were smokers. CAS was performed for left internal carotid artery (ICA) in 113 (45.4%) patients. Fourteen (5.6%) patients had sequential bilateral stenting. Mean stenosis of operated ICA was 80.2 ± 13.8%. An embolic protection device was used in 203 (96.2%) patients. Pre- and postdilation were performed in 39 (18.5%) and 182 (86.3%) patients, respectively. Composite outcomes were observed in 3.6% of patients (3.2% stroke, 0% myocardial infarction, and 1.2% death). Left-sided lesions and the presence of diabetes mellitus were significantly associated with poor short-term outcome (p = 0.025 and p = 0.020, respectively). CONCLUSION: There was a higher risk of short-term major complications in diabeticpatients and for left carotid artery intervention.
Entities:
Keywords:
Carotid artery angioplasty and stenting; Cerebrovascular disease; Outcome; Stroke
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