Journal article
Safety and efficacy of symptomatic carotid artery stenting performed in an emergency setting
Interventional neuroradiology, Vol.27(3), pp.411-418
12/06/2020
DOI: 10.1177/1591019920977552
PMCID: PMC8190945
PMID: 33283595
Abstract
INTRODUCTIONCarotid artery stenting (CAS) has increasingly emerged as an alternative strategy to carotid endarterectomy in the treatment of patients with symptomatic carotid stenosis. Optimal timing for CAS after symptoms onset remains unclear. We aimed to evaluate the safety and efficacy of CAS when performed in an emergency setting. PATIENTS AND METHODSWe performed a retrospective analysis of CAS patients admitted to our CSC with symptomatic extracranial carotid occlusion or significant stenosis from January 2014-September 2019. Emergency CAS was defined as CAS performed during the same hospitalization from TIA/stroke onset, whereas elective CAS as CAS performed on a subsequent admission. The primary outcome was defined as the occurrence of any stroke, myocardial infarction, or death related to the procedure at 3 months of follow-up. Secondary outcomes included periprocedural complications and the rate of restenosis/occlusion at follow-up. Logistic regression and survival analyses were used to compare outcomes and restenosis at follow-up. RESULTSWe identified 75 emergency and 104 elective CAS patients. Emergency CAS patients had significantly higher rates of ipsilateral carotid occlusion (17% vs. 2%, p < 0.001) and use of general anesthesia (19% vs. 4%, p = 0.001) than elective CAS. There were no significant differences between emergency and elective CAS in the primary (5.7% vs. 1%, p = 0.161) and secondary (9% vs. 4.8%, p = 0.232) outcomes. We did not find differences in the rate of restenosis/occlusion (7% vs. 11.6%; log-rank test p = 0.3) at a median of 13 months follow-up. CONCLUSIONIn our study, emergency CAS in symptomatic patients might have a similar safety and efficacy profile to elective CAS at 3 months and long-term follow-up.
Details
- Title: Subtitle
- Safety and efficacy of symptomatic carotid artery stenting performed in an emergency setting
- Creators
- Darko Quispe-Orozco - Univ Iowa Hosp & Clin, Dept Neurol, Iowa City, IA 52242 USAKaustubh Limaye - Univ Iowa Hosp & Clin, Dept Neurol, Iowa City, IA 52242 USACynthia B Zevallos - Univ Iowa Hosp & Clin, Dept Neurol, Iowa City, IA 52242 USAMudassir Farooqui - Univ Iowa Hosp & Clin, Dept Neurol, Iowa City, IA 52242 USAAlan Mendez-Ruiz - Univ Iowa Hosp & Clin, Dept Neurol, Iowa City, IA 52242 USASameer Ansari - Univ Iowa Hosp & Clin, Dept Neurol, Iowa City, IA 52242 USAAndres Dajles - Univ Iowa Hosp & Clin, Dept Neurol, Iowa City, IA 52242 USAEdgar A Samaniego - Univ Iowa Hosp & Clin, Dept Neurol, Iowa City, IA 52242 USAColin Derdeyn - Univ Iowa Hosp & Clin, Dept Radiol, Iowa City, IA 52242 USASantiago Ortega-Gutierrez - Univ Iowa Hosp & Clin, Dept Neurol, Iowa City, IA 52242 USA
- Resource Type
- Journal article
- Publication Details
- Interventional neuroradiology, Vol.27(3), pp.411-418
- DOI
- 10.1177/1591019920977552
- PMID
- 33283595
- PMCID
- PMC8190945
- NLM abbreviation
- Interv Neuroradiol
- ISSN
- 1591-0199
- eISSN
- 2385-2011
- Language
- English
- Date published
- 12/06/2020
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984070304602771
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