Journal article
Safety and Feasibility of Symptomatic Carotid Artery Stent-Assisted Revascularization within 48 Hours after Symptoms Onset
Journal of stroke and cerebrovascular diseases, Vol.30(6), pp.105743-105743
06/2021
DOI: 10.1016/j.jstrokecerebrovasdis.2021.105743
PMID: 33765635
Abstract
We aimed to evaluate the safety and feasibility of carotid artery stenting (CAS) performed in the hyperacute period.
We analyzed a retrospective database of CAS patients from our center. We included patients with symptomatic isolated ipsilateral extracranial carotid stenosis and acute tandem occlusions who underwent CAS. Hyperacute CAS (HCAS) and acute CAS (ACAS) groups were defined as CAS within 48 hours and >48 hours to 14 days from symptoms onset, respectively. The primary outcome was a composite of any stroke, myocardial infarction, or death at 3 months of follow-up. Secondary outcomes were periprocedural complications and restenosis or occlusion rates.
We included 97 patients, 39 with HCAS and 58 with ACAS. There was no significant difference between groups for the primary outcome (HCAS 3.3% vs. ACAS 6.1%; p = 1). There were no differences in the rate of perioperative complications between groups although a trend was observed (HCAS 15.3% vs. ACAS 3.4%; p = .057). The rate of restenosis or occlusion between groups (HCAS 8.1% vs. ACAS 9,1%; log-rank test p = .8) was similar with a median time of follow-up of 13.7 months.
Based on this study, CAS may be feasible in the hyperacute period. However, there are potential higher rates of perioperative complications in the hyperacute group, primarily occurring in MT patients with acute tandem occlusion. A larger multicenter study may be needed to further corroborate our findings.
Details
- Title: Subtitle
- Safety and Feasibility of Symptomatic Carotid Artery Stent-Assisted Revascularization within 48 Hours after Symptoms Onset
- Creators
- Kaustubh Limaye - Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USADarko Quispe-Orozco - Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USACynthia B Zevallos - Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USAMudassir Farooqui - Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USASudeepta Dandapat - Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USAAlan Mendez-Ruiz - Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USASameer Ansari - Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USASamir Abdelkarim - Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USAAndres Dajles - Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USAColin Derdeyn - Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, USAEdgar A Samaniego - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USASantiago Ortega-Gutierrez - Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
- Resource Type
- Journal article
- Publication Details
- Journal of stroke and cerebrovascular diseases, Vol.30(6), pp.105743-105743
- DOI
- 10.1016/j.jstrokecerebrovasdis.2021.105743
- PMID
- 33765635
- NLM abbreviation
- J Stroke Cerebrovasc Dis
- ISSN
- 1052-3057
- eISSN
- 1532-8511
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 06/2021
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984070291502771
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