Early carotid artery stenting for symptomatic carotid artery stenosis

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: The aim of present study was to assess safety and efficacy of early carotid artery stent (CAS) in patients with symptomatic carotid artery stenosis compared with delayed CAS. Methods: This retrospective study was approved by the institutional review board, and the requirement to obtain written informed consent was waived. Outcomes of 206 patients with symptomatic carotid stenosis who were treated by CAS were analyzed. According to CAS timing from last symptom, patients were divided into early (within 2 weeks, 74 [35.0 %]) and delayed (after 2 weeks, 112 [64.1 %]) group by CAS timing from the last symptom. Procedural complication and early (≤30 days of CAS) event (ipsilateral stroke or any death) for safety, and late (31 days to 1 year of CAS) event for efficacy of CAS preventing further stroke were evaluated. The two groups were compared using Cox proportional hazard analysis. Results: No difference was found in procedural complication between the groups (early 2 [2.7 %] vs. delayed group 7 [5.3 %], hazard ratio [HR] 0.61, 95 % confidence interval [CI] 0.123–2.979, p = 0.537). In the early group, however, early event developed more frequently than in the late group (9 [12.2 %] vs. 1 [0.8 %], HR 16.05, 95 % CI 1.991–129.438, p = 0.009). The late event rate showed no difference between the two groups (4 [5.4 %] vs. 4 [3.0 %], HR 2.09, 95 % CI 0.484–8.989, p = 0.324). Conclusions: Early CAS is not safe during periprocedural period, compared with late CAS. In CAS for symptomatic carotid stenosis, delayed CAS should be considered.

Original languageEnglish
Pages (from-to)1873-1878
Number of pages6
JournalActa Neurochirurgica
Volume157
Issue number11
DOIs
StatePublished - 1 Nov 2015

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Carotid Stenosis
Carotid Arteries
Stents
Confidence Intervals
Stroke
Safety
Research Ethics Committees
Informed Consent
Retrospective Studies

Keywords

  • Carotid artery stenosis
  • Complications
  • Delayed carotid stenting
  • Early carotid artery stenting

Cite this

@article{f9df956f818f4148b684533d87485c96,
title = "Early carotid artery stenting for symptomatic carotid artery stenosis",
abstract = "Background: The aim of present study was to assess safety and efficacy of early carotid artery stent (CAS) in patients with symptomatic carotid artery stenosis compared with delayed CAS. Methods: This retrospective study was approved by the institutional review board, and the requirement to obtain written informed consent was waived. Outcomes of 206 patients with symptomatic carotid stenosis who were treated by CAS were analyzed. According to CAS timing from last symptom, patients were divided into early (within 2 weeks, 74 [35.0 {\%}]) and delayed (after 2 weeks, 112 [64.1 {\%}]) group by CAS timing from the last symptom. Procedural complication and early (≤30 days of CAS) event (ipsilateral stroke or any death) for safety, and late (31 days to 1 year of CAS) event for efficacy of CAS preventing further stroke were evaluated. The two groups were compared using Cox proportional hazard analysis. Results: No difference was found in procedural complication between the groups (early 2 [2.7 {\%}] vs. delayed group 7 [5.3 {\%}], hazard ratio [HR] 0.61, 95 {\%} confidence interval [CI] 0.123–2.979, p = 0.537). In the early group, however, early event developed more frequently than in the late group (9 [12.2 {\%}] vs. 1 [0.8 {\%}], HR 16.05, 95 {\%} CI 1.991–129.438, p = 0.009). The late event rate showed no difference between the two groups (4 [5.4 {\%}] vs. 4 [3.0 {\%}], HR 2.09, 95 {\%} CI 0.484–8.989, p = 0.324). Conclusions: Early CAS is not safe during periprocedural period, compared with late CAS. In CAS for symptomatic carotid stenosis, delayed CAS should be considered.",
keywords = "Carotid artery stenosis, Complications, Delayed carotid stenting, Early carotid artery stenting",
author = "Song, {Kyung Sun} and Kwon, {O. Ki} and Gyojun Hwang and Bae, {Hee Joon} and Han, {Moon Ku} and Kim, {Beom Joon} and Bang, {Jae Seung} and Oh, {Chang Wan}",
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Early carotid artery stenting for symptomatic carotid artery stenosis. / Song, Kyung Sun; Kwon, O. Ki; Hwang, Gyojun; Bae, Hee Joon; Han, Moon Ku; Kim, Beom Joon; Bang, Jae Seung; Oh, Chang Wan.

In: Acta Neurochirurgica, Vol. 157, No. 11, 01.11.2015, p. 1873-1878.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Early carotid artery stenting for symptomatic carotid artery stenosis

AU - Song, Kyung Sun

AU - Kwon, O. Ki

AU - Hwang, Gyojun

AU - Bae, Hee Joon

AU - Han, Moon Ku

AU - Kim, Beom Joon

AU - Bang, Jae Seung

AU - Oh, Chang Wan

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Background: The aim of present study was to assess safety and efficacy of early carotid artery stent (CAS) in patients with symptomatic carotid artery stenosis compared with delayed CAS. Methods: This retrospective study was approved by the institutional review board, and the requirement to obtain written informed consent was waived. Outcomes of 206 patients with symptomatic carotid stenosis who were treated by CAS were analyzed. According to CAS timing from last symptom, patients were divided into early (within 2 weeks, 74 [35.0 %]) and delayed (after 2 weeks, 112 [64.1 %]) group by CAS timing from the last symptom. Procedural complication and early (≤30 days of CAS) event (ipsilateral stroke or any death) for safety, and late (31 days to 1 year of CAS) event for efficacy of CAS preventing further stroke were evaluated. The two groups were compared using Cox proportional hazard analysis. Results: No difference was found in procedural complication between the groups (early 2 [2.7 %] vs. delayed group 7 [5.3 %], hazard ratio [HR] 0.61, 95 % confidence interval [CI] 0.123–2.979, p = 0.537). In the early group, however, early event developed more frequently than in the late group (9 [12.2 %] vs. 1 [0.8 %], HR 16.05, 95 % CI 1.991–129.438, p = 0.009). The late event rate showed no difference between the two groups (4 [5.4 %] vs. 4 [3.0 %], HR 2.09, 95 % CI 0.484–8.989, p = 0.324). Conclusions: Early CAS is not safe during periprocedural period, compared with late CAS. In CAS for symptomatic carotid stenosis, delayed CAS should be considered.

AB - Background: The aim of present study was to assess safety and efficacy of early carotid artery stent (CAS) in patients with symptomatic carotid artery stenosis compared with delayed CAS. Methods: This retrospective study was approved by the institutional review board, and the requirement to obtain written informed consent was waived. Outcomes of 206 patients with symptomatic carotid stenosis who were treated by CAS were analyzed. According to CAS timing from last symptom, patients were divided into early (within 2 weeks, 74 [35.0 %]) and delayed (after 2 weeks, 112 [64.1 %]) group by CAS timing from the last symptom. Procedural complication and early (≤30 days of CAS) event (ipsilateral stroke or any death) for safety, and late (31 days to 1 year of CAS) event for efficacy of CAS preventing further stroke were evaluated. The two groups were compared using Cox proportional hazard analysis. Results: No difference was found in procedural complication between the groups (early 2 [2.7 %] vs. delayed group 7 [5.3 %], hazard ratio [HR] 0.61, 95 % confidence interval [CI] 0.123–2.979, p = 0.537). In the early group, however, early event developed more frequently than in the late group (9 [12.2 %] vs. 1 [0.8 %], HR 16.05, 95 % CI 1.991–129.438, p = 0.009). The late event rate showed no difference between the two groups (4 [5.4 %] vs. 4 [3.0 %], HR 2.09, 95 % CI 0.484–8.989, p = 0.324). Conclusions: Early CAS is not safe during periprocedural period, compared with late CAS. In CAS for symptomatic carotid stenosis, delayed CAS should be considered.

KW - Carotid artery stenosis

KW - Complications

KW - Delayed carotid stenting

KW - Early carotid artery stenting

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