Faculty Collaboration Database

High-risk anatomic variables and plaque characteristics in carotid artery stenting. Vasc Endovascular Surg 2014;48(7-8):452-9

Date

09/26/2014

Pubmed ID

25252921

DOI

10.1177/1538574414551577

Scopus ID

2-s2.0-84927713073 (requires institutional sign-in at Scopus site)   10 Citations

Abstract

OBJECTIVES: To determine anatomic and plaque-related risk factors for patients undergoing carotid artery stenting.

METHODS: A retrospective review of patients from a prospectively maintained database undergoing carotid artery stenting at our institution between 2001 and 2010 was performed. Preoperative imaging studies (ie, ultrasound, computed tomography angiography, magnetic resonance angiography, and angiograms) were reviewed for specific anatomic criteria and plaque characteristics. Primary outcomes included 30-day stroke or transient ischemic attack (TIA). Secondary outcomes included 30-day death and myocardial infarction (MI). Statistical significance was assumed for P = .05.

RESULTS: Imaging was reviewed for 381 carotid arteries in 375 patients. There were 14 (3.7%) perioperative neurologic events, which included 8 TIA and 6 strokes. Thirty-day mortality and MI were 0.5% and 0.75%, respectively. Degree of internal carotid artery stenosis was associated with primary outcomes (P = .03), and the presence of arch calcification trended toward an increase in primary outcomes (P = .07). However, arch type, ostial involvement, tandem lesions, and plaque calcification did not correlate with primary outcomes. Differences were noted between the sexes, with females having more common carotid artery tortuosity than males (34% vs 27%, P = .04). Females also had a trend toward more plaque calcification and more severe arch calcification than males. These differences did not translate to differences in perioperative neurologic events.

CONCLUSION: Our data suggest that degree of internal carotid artery stenosis and aortic arch calcification may be associated with increased perioperative neurologic risk during carotid stenting, but arch type is not.

Author List

Morgan CE, Lee CJ, Chin JA, Eskandari MK, Morasch MD, Rodriguez HE, Helenowski IB, Kibbe MR

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Angioplasty, Balloon
Aorta, Thoracic
Aortic Diseases
Carotid Artery, Internal
Carotid Stenosis
Chicago
Databases, Factual
Diagnostic Imaging
Female
Humans
Ischemic Attack, Transient
Male
Middle Aged
Myocardial Infarction
Plaque, Atherosclerotic
Predictive Value of Tests
Retrospective Studies
Risk Factors
Severity of Illness Index
Stents
Stroke
Time Factors
Treatment Outcome
Vascular Calcification