The impact of timing on outcomes of carotid artery stenting in recently symptomatic patients.

Abstract:

OBJECTIVES:We sought to determine whether the timing of carotid artery stenting (CAS) affects peri-procedural outcomes in recently symptomatic patients. BACKGROUND:Early carotid endarterectomy following a stroke lowers the risk of recurrent ischemic events but has been associated with an increased risk of intracerebral hemorrhage. The optimal timing of CAS following a stroke is unknown. METHODS:Using a single-center prospective CAS registry, we retrospectively analyzed data on consecutive CAS procedures over an 8-year period. Patients were separated into early (≤4 weeks) and late (>4 weeks) treatment groups based on time to CAS from symptom onset. Post-procedural hypertension was treated. Thirty-day incidence of stroke, intracerebral hemorrhage, myocardial infarction and death were recorded. RESULTS:A total of 224 patients were treated for symptomatic lesions. The mean age was 71±10 years, and 63% were men. The median time for CAS was 8 days (0.2-30 days) and 90 days (31-180 days) respectively, for the early (n=122) and late (n=102) intervention groups. There were 4 (3.45%) periprocedural strokes in the early and 5 (5.95%) in the late CAS group (p=0.5). There was one hyperperfusion syndrome in each group. The 30-day stroke, myocardial infarction or death rates were similar between the early (6.03%) and late (8.33%) CAS groups, p=0.58. A multivariate analysis showed that age >80 years rather than timing of CAS was associated with adverse events. CONCLUSIONS:CAS may be performed safely immediately following non-disabling strokes. Octogenarians may be at higher risk of complications.

journal_name

J Neurointerv Surg

authors

Lin R,Mazighi M,Yadav J,Abou-Chebl A

doi

10.1136/jnis.2009.000901

subject

Has Abstract

pub_date

2010-03-01 00:00:00

pages

55-8

issue

1

eissn

1759-8478

issn

1759-8486

pii

jnis.2009.000901

journal_volume

2

pub_type

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