Residual stenosis after carotid artery stenting: Effect on periprocedural and long-term outcomes

English version

Autoři: Jihoon Kang ^aff001; Jeong-Ho Hong ^aff002; Beom Joon Kim ^aff001; Hee-Joon Bae ^aff001; O-Ki Kwon ^aff003; Chang Wan Oh ^aff003; Cheolkyu Jung ^aff004; Ji Sung Lee ^aff005; Moon-Ku Han ^aff001
Působiště autorů: Department of Neurology, Seoul National University Bundang Hospital, Seoul National University, Seongnam, Republic of Korea ^aff001; Department of Neurology, Dongsan Medical Center, Keimyung University, Daegu, Republic of Korea ^aff002; Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University, Seongnam, Republic of Korea ^aff003; Department of Radiology, Seoul National University Bundang Hospital, Seoul National University, Seongnam, Republic of Korea ^aff004; Clinical Research Center, Asan Medical Center, Ulsan University, Seoul, Republic of Korea ^aff005
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0216592

Souhrn

Objective

This study investigated the effect of residual stenosis after carotid artery stenting (CAS) on periprocedural and long-term outcomes.

Methods

Patients treated with CAS for symptomatic or asymptomatic carotid arterial stenosis were consecutively enrolled. Residual stenosis was estimated from post-procedure angiography findings. The effects of residual stenosis on 30-day periprocedural outcome and times to restenosis and clinical outcome were analyzed using logistic regression models and Wei-Lin-Weissfeld models, respectively.

Results

A total of 412 patients (age, 64.7 ± 17.0 years; male, 82.0%) were enrolled. The median baseline stenosis was 80% (interquartile range [IQR], 70–90%), which improved to 10% (0–30%) for residual stenosis. Residual stenosis was significantly associated with periprocedural outcome (adjusted odds ratio, 0.983; 95% confidence interval [CI], 0.965–0.999, P = 0.01) after adjustment for baseline stenosis, age, hypertension, symptomaticity, and statin use. Over the 5-year observation period, residual stenosis did not increase the global hazard for restenosis and clinical outcome (adjusted hazard ratio, 1.011; 95% CI, 0.997–1.025. In the event-specific model, residual stenosis increased the hazard for restenosis (adjusted hazard ratio, 1.041; 1.012–1.072) but not for clinical outcome (adjusted hazard ratio, 1.011; 0.997–1.025).

Conclusions

Residual stenosis after carotid artery stenting may be useful to predict periprocedural outcome and restenosis.

Klíčová slova:

stroke – Biology and life sciences – Anatomy – Medicine and health sciences – Pathology and laboratory medicine – Diagnostic medicine – Signs and symptoms – Pharmacology – Hematology – Neurology – Drugs – Cerebrovascular diseases – Ischemic stroke – Hemorrhagic stroke – Vascular medicine – Cardiology – Surgical and invasive medical procedures – Cardiovascular anatomy – Stenosis – Blood vessels – Arteries – Carotid arteries – Statins – Stent implantation – Hemodynamics – Myocardial infarction

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