Carotid Artery Stenting in Patients with Symptomatic and Asymptomatic Stenosis: In-Hospital Clinical Outcomes at a Single Neurovascular Center
Background: Carotid artery stenting (CAS) is a minimally invasive and proven percutaneous procedure that is widely used to treat patients with symptomatic and asymptomatic carotid artery stenosis. The purpose of this study was to characterize the in-hospital outcomes of symptomatic and asymptomatic...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-04-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/11/8/2086 |
| _version_ | 1797434485095006208 |
|---|---|
| author | Kamran Hajiyev Victoria Hellstern Alexandru Cimpoca Christina Wendl Hansjörg Bäzner Hans Henkes Philipp von Gottberg |
| author_facet | Kamran Hajiyev Victoria Hellstern Alexandru Cimpoca Christina Wendl Hansjörg Bäzner Hans Henkes Philipp von Gottberg |
| author_sort | Kamran Hajiyev |
| collection | DOAJ |
| description | Background: Carotid artery stenting (CAS) is a minimally invasive and proven percutaneous procedure that is widely used to treat patients with symptomatic and asymptomatic carotid artery stenosis. The purpose of this study was to characterize the in-hospital outcomes of symptomatic and asymptomatic patients undergoing CAS at a single neurovascular center. Methods: The study was conducted as a retrospective analysis of 1158 patients (asymptomatic, <i>n</i> = 636; symptomatic, <i>n</i> = 522; male, <i>n</i> = 816; median age, 71 years; NASCET method, 70–99% stenosis, <i>n</i> = 830) who underwent CAS between May 2009 and December 2020. In-hospital neurological outcomes, adverse reactions to iodinated contrast media, acute myocardial infarction, intraprocedural complications, and access-site issues were evaluated. The primary endpoints were disabling stroke (including disabling cerebral hyperperfusion syndrome [CHS]) and all in-hospital deaths. Results: A carotid stent could not be deployed in one patient due to calcified plaques (technical failure rate of 0.09%). Four patients (0.3%) experienced in-hospital, stroke-associated death, while five patients (0.4%) died from non-stroke-related causes. All stroke-associated deaths occurred in the symptomatic group and were due to CHS. The disabling stroke rate was 0.9% overall (<i>n</i> = 10; 0.5% versus 1.3% in asymptomatic versus symptomatic patients, respectively). Nineteen patients (1.6%) reached the in-hospital primary endpoint. More patients in the symptomatic group achieved this endpoint than in the asymptomatic group (2.5% versus 0.9%, respectively; <i>p</i> = 0.060). Conclusions: An evaluation was conducted on the in-hospital outcomes of 1158 patients at a single center who underwent CAS and was performed by trained physicians who were supervised by a senior neurovascular interventionist with over 20 years of experience, confirming the excellent safety profile of this procedure with a low rate of complications. |
| first_indexed | 2024-03-09T10:32:53Z |
| format | Article |
| id | doaj.art-400cbb2792964fb4b8dc60e5e21c7b2d |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T10:32:53Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-400cbb2792964fb4b8dc60e5e21c7b2d2023-12-01T21:06:25ZengMDPI AGJournal of Clinical Medicine2077-03832022-04-01118208610.3390/jcm11082086Carotid Artery Stenting in Patients with Symptomatic and Asymptomatic Stenosis: In-Hospital Clinical Outcomes at a Single Neurovascular CenterKamran Hajiyev0Victoria Hellstern1Alexandru Cimpoca2Christina Wendl3Hansjörg Bäzner4Hans Henkes5Philipp von Gottberg6Neuroradiologische Klinik, Klinikum Stuttgart, D-70174 Stuttgart, GermanyNeuroradiologische Klinik, Klinikum Stuttgart, D-70174 Stuttgart, GermanyNeuroradiologische Klinik, Klinikum Stuttgart, D-70174 Stuttgart, GermanyInstitut für Röntgendiagnostik, Zentrum für Neuroradiologie, Fakultät für Medizin, Universität Regensburg, D-93053 Regensburg, GermanyNeurologische Klinik, Klinikum Stuttgart, D-70174 Stuttgart, GermanyNeuroradiologische Klinik, Klinikum Stuttgart, D-70174 Stuttgart, GermanyNeuroradiologische Klinik, Klinikum Stuttgart, D-70174 Stuttgart, GermanyBackground: Carotid artery stenting (CAS) is a minimally invasive and proven percutaneous procedure that is widely used to treat patients with symptomatic and asymptomatic carotid artery stenosis. The purpose of this study was to characterize the in-hospital outcomes of symptomatic and asymptomatic patients undergoing CAS at a single neurovascular center. Methods: The study was conducted as a retrospective analysis of 1158 patients (asymptomatic, <i>n</i> = 636; symptomatic, <i>n</i> = 522; male, <i>n</i> = 816; median age, 71 years; NASCET method, 70–99% stenosis, <i>n</i> = 830) who underwent CAS between May 2009 and December 2020. In-hospital neurological outcomes, adverse reactions to iodinated contrast media, acute myocardial infarction, intraprocedural complications, and access-site issues were evaluated. The primary endpoints were disabling stroke (including disabling cerebral hyperperfusion syndrome [CHS]) and all in-hospital deaths. Results: A carotid stent could not be deployed in one patient due to calcified plaques (technical failure rate of 0.09%). Four patients (0.3%) experienced in-hospital, stroke-associated death, while five patients (0.4%) died from non-stroke-related causes. All stroke-associated deaths occurred in the symptomatic group and were due to CHS. The disabling stroke rate was 0.9% overall (<i>n</i> = 10; 0.5% versus 1.3% in asymptomatic versus symptomatic patients, respectively). Nineteen patients (1.6%) reached the in-hospital primary endpoint. More patients in the symptomatic group achieved this endpoint than in the asymptomatic group (2.5% versus 0.9%, respectively; <i>p</i> = 0.060). Conclusions: An evaluation was conducted on the in-hospital outcomes of 1158 patients at a single center who underwent CAS and was performed by trained physicians who were supervised by a senior neurovascular interventionist with over 20 years of experience, confirming the excellent safety profile of this procedure with a low rate of complications.https://www.mdpi.com/2077-0383/11/8/2086carotid artery stenosisneurointerventioncarotid artery stentingendovascular treatmentstroke |
| spellingShingle | Kamran Hajiyev Victoria Hellstern Alexandru Cimpoca Christina Wendl Hansjörg Bäzner Hans Henkes Philipp von Gottberg Carotid Artery Stenting in Patients with Symptomatic and Asymptomatic Stenosis: In-Hospital Clinical Outcomes at a Single Neurovascular Center Journal of Clinical Medicine carotid artery stenosis neurointervention carotid artery stenting endovascular treatment stroke |
| title | Carotid Artery Stenting in Patients with Symptomatic and Asymptomatic Stenosis: In-Hospital Clinical Outcomes at a Single Neurovascular Center |
| title_full | Carotid Artery Stenting in Patients with Symptomatic and Asymptomatic Stenosis: In-Hospital Clinical Outcomes at a Single Neurovascular Center |
| title_fullStr | Carotid Artery Stenting in Patients with Symptomatic and Asymptomatic Stenosis: In-Hospital Clinical Outcomes at a Single Neurovascular Center |
| title_full_unstemmed | Carotid Artery Stenting in Patients with Symptomatic and Asymptomatic Stenosis: In-Hospital Clinical Outcomes at a Single Neurovascular Center |
| title_short | Carotid Artery Stenting in Patients with Symptomatic and Asymptomatic Stenosis: In-Hospital Clinical Outcomes at a Single Neurovascular Center |
| title_sort | carotid artery stenting in patients with symptomatic and asymptomatic stenosis in hospital clinical outcomes at a single neurovascular center |
| topic | carotid artery stenosis neurointervention carotid artery stenting endovascular treatment stroke |
| url | https://www.mdpi.com/2077-0383/11/8/2086 |
| work_keys_str_mv | AT kamranhajiyev carotidarterystentinginpatientswithsymptomaticandasymptomaticstenosisinhospitalclinicaloutcomesatasingleneurovascularcenter AT victoriahellstern carotidarterystentinginpatientswithsymptomaticandasymptomaticstenosisinhospitalclinicaloutcomesatasingleneurovascularcenter AT alexandrucimpoca carotidarterystentinginpatientswithsymptomaticandasymptomaticstenosisinhospitalclinicaloutcomesatasingleneurovascularcenter AT christinawendl carotidarterystentinginpatientswithsymptomaticandasymptomaticstenosisinhospitalclinicaloutcomesatasingleneurovascularcenter AT hansjorgbazner carotidarterystentinginpatientswithsymptomaticandasymptomaticstenosisinhospitalclinicaloutcomesatasingleneurovascularcenter AT hanshenkes carotidarterystentinginpatientswithsymptomaticandasymptomaticstenosisinhospitalclinicaloutcomesatasingleneurovascularcenter AT philippvongottberg carotidarterystentinginpatientswithsymptomaticandasymptomaticstenosisinhospitalclinicaloutcomesatasingleneurovascularcenter |