Abstract
Abstract WP6: Safety of Acute Carotid Stenting Treatment in Acute Symptomatic Patients
Stroke (1970), Vol.51(Suppl_1)
02/2020
DOI: 10.1161/str.51.suppl_1.WP6
Abstract
Carotid stenting (CAS) has been shown to be equivalent to carotid endarterectomy in symptomatic patients; however its optimal timing remains unclear. In this study, we aim to evaluate the safety of CAS when performed within the first 48 hours of symptom onset. We performed a retrospective analysis of a prospectively collected database of consecutive CAS patients admitted to our comprehensive stroke center with TIA/stroke and ipsilateral symptomatic carotid stenosis >50% from 2014 to 2019. Medical records were retrospectively reviewed for demographic, clinical and procedural data and outcomes. Acute and delayed treatment were defined as ≤48 and >48 hours from last known well (LKW) respectively. The primary endpoint was procedure-related major complications (stroke with NIHSS increase of ≥4, myocardial infarction, parenchymal hemorrhage type 2 or death) ≤30 days after CAS. Secondary endpoints were procedure-related minor neurological (stroke with NIHSS increase of <4 and reperfusion injury) and non-neurological (groin puncture hematoma, acute anemia and arrhythmia) complications. Functional outcome was assessed by discharge and 90 days mRS, dichotomized as good (0-2) and bad (3-6). A total of 72 patients were included in the analysis, 36 in each group. There was no difference in age, NIHSS at presentation, gender, incidence of TIA as presentation or percentage of TPA received. The acute group differed significantly from the delayed group in number of thrombectomies (36.1% vs. 5.6%, p=0.001) and median time from LKW to CAS (15.9 hours vs. 88.0 hours, p<0.001). There were significantly more carotid occlusions in the acute group when compared to the delayed group (37.8% vs. 2.2, p<0.0001). Overall, the acute group did not show significant difference from the delayed group in major (2.8% vs. 5.6%, p=1.0), minor neurological (13.9% vs. 2.8%, p=0.09) and minor non-neurological complication rates (13.9% vs. 8.3%, p=0.7). Rates of good outcomes were not significantly different between the two groups at discharge (52.8% vs. 50%) or 90 days (75% vs. 63%). CAS can be performed safely in acute symptomatic carotid stenosis patients within the first 48 hours from symptom onset.
Details
- Title: Subtitle
- Abstract WP6: Safety of Acute Carotid Stenting Treatment in Acute Symptomatic Patients
- Creators
- Darko Quispe-Orozco - University of IowaKaustubh Limaye - University of IowaCynthia Zevallos - University of IowaAndrea Holcombe - University of IowaSudeepta Dandapat - University of IowaSameer Ansari - Univ of Iowa Hosps, Iowa City, IAKhaled Asi - Univ of Iowa Hosps, Iowa City, IAEdgar Samaniego - University of IowaDavid Hasan - University of IowaColin Derdeyn - University of IowaSantiago Ortega-Gutierrez - University of Iowa
- Resource Type
- Abstract
- Publication Details
- Stroke (1970), Vol.51(Suppl_1)
- DOI
- 10.1161/str.51.suppl_1.WP6
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Language
- English
- Date published
- 02/2020
- Academic Unit
- Neurosurgery; Roy J. Carver Department of Biomedical Engineering; Internal Medicine; Radiology; Neurology; Iowa Neuroscience Institute
- Record Identifier
- 9984303446202771
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