Periprocedural Complications and Long-term Clinical Follow-up of Carotid Artery Angioplasty – Results from Practice
Authors:
D. Krajíčková 1,2; A. Krajina 1,2; Miroslav Lojík 1,2
; V. Chovanec 1,2; J. Raupach 1,2; I. Guňka 1,3; M. Vališ 1,2
Authors place of work:
Komplexní cerebrovaskulární centrum, LF UK a FN Hradec Králové
1; Neurologická klinika, LF UK a FN Hradec Králové
2; Radiologická klinika, LF UK a FN Hradec Králové
3; Chirurgická klinika, LF UK a FN Hradec Králové
4
Published in the journal:
Cesk Slov Neurol N 2016; 79/112(3): 317-322
Category:
Original Paper
Summary
Aim:
Carotid artery angioplasty is a preventive measure to decrease a risk of cerebral ischemia due to stenosis of the internal carotid artery bifurcation. To achieve this purpose, it is crucial that the procedure has a minimal risk of complications and its effect is long-lasting. The purpose of our study was to verify safety of carotid angioplasty and its long-term effect in clinical practice.
Material and method:
The study included 450 patients with 442 carotid artery stents and 8 plain carotid angioplasties since 1997. Complications occurring during the first three days after the procedure (periprocedural complications) and during long-term clinical and ultrasonographical follow-up (median 33 months) were recorded.
Results:
The risk associated with carotid angioplasty was low: in hospital mortality due to intracerebral hemorrhage was 0.5%, minor stroke occurred in 1.0%, transient ischemic attack in 2.4%. > 70% restenosis was found in 3.6% of the 76% of all patients who had long-term follow-up. Asymptomatic restenoses were 81%.
Conclusions:
Our results confirmed that carotid angioplasty is a safe method with beneficial long-term effect if it is done for appropriate indication and performed by a skilled intervention radiologist.
Key words:
carotid stenting – periprocedural complication – long-term follow-up – restenosis
The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.
The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.
Zdroje
1. Wimmer NJ, Yeh RW, Cutlip DE, et al. Risk prediction for adverse events after carotid stenting in higher surgical risk patients. Stroke 2012;4(12):3218–24. doi: 10.1161/STROKEAHA.112.673194.
2. Rothwell PM, Slattery J, Warlow CP. Clinical and angiographic predictors of stroke and death from carotid endarterectomy: systematic review. BMJ 1997;315(7122):1571–7.
3. Frawley JE, Hicks RG, Woodforth IJ. Risk factors for perioperative stroke complicating carotid endarterectomy: selective analysis of a prospective audit of 1,000 consecutive operations. Aust NZJ Surg 2000;70(1):52–6.
4. Touzé E, Trinquart L, Chatellier G, et al. Systematic review of the perioperative risks of stroke or death after carotid angioplasty and stenting. Stroke 2009;40(12):e683–93. doi: 10.1161/STROKEAHA.109.562041.
5. Al-Mubarak N, Roubin GS, Iyer SS, et al. Carotid artery stenting. Current practice and techniques. Philadelphia: Lippincott Williams & Williams 2004.
6. Chiam PT, Roubin GS, Iyer SS, et al. Carotid artery stenting in elderly patients: importance of case selection. Catheter Cardiovasc Interv 2008;72(3):318–24. doi: 10.1002/ccd.21620.
7. Bonati LH, Dobson J, Algra A, et al. Short-term outcomes after stenting versus endarterectomy for symptomatic carotid stenosis. A preplanned meta-analysis of individual patient data. Lancet 2010;376(9746):1062–73. doi: 10.1016/S0140-6736(10)61009-4.
8. Chaturvedi S, Matsumura JS, Gray W, et al. Carotid artery stenting in octogenarians. Periprocedural stroke risk predictor analysis from the multicenter carotid ACCULINK/ACCUNET Post Approval Trial to Uncover Rare Events (CAPTURE 2) clinical trial. Stroke 2010;41(4):757–64. doi: 10.1161/STROKEAHA.109.569426.
9. Voeks JH, Howard G, Roubin GS, et al. Age and outcomes after carotid stenting and endarterectomy: the carotid revascularization endarterectomy versus stenting trial. Stroke 2011;42(12):3484–90. doi: 10.1161/STROKEAHA.111.624155.
10. Krajina A, Náhlovský J, Krajíčková D. Endovaskulární léčebné výkony v neurochirurgii. In: Náhlovský J et al. Neurochirurgie. 1. vyd. Praha: Galén, Karolinum 2005:229–53.
11. Krajíčková D, Krajina A, Lojík M, et al. Naše zkušenosti s angioplastikami mozkových tepen. Cesk Slov Neurol N 2005;68/101(4):241–50.
12. Krajíčková D, Krajina A, Nová M, et al. Fatal intraventricular hemorrhage after the extracranial carotid artery angioplasty and stent placement. Cardiovasc Intervent Radiol 2005;28(4):502–5.
13. Eckstein HH, Ringleb P, Allenberg JR, et al. Results of the stent-protected angioplasty versus carotid endarterectomy (SPACE) study to treat symptomatic stenosis at 2 years: a multinational, prospective, randomized trial. Lancet Neurol 2008;7(10):893–902. doi: 10.1016/S1474-4422(08)70196-0.
14. Keldahl ML, Park MS, Garcia-Toca M. Does a contralateral carotid occlusion adversely impact carotid artery stenting outcomes? Ann Vasc Surg 2012;26(1):40–5. doi: 10.1016/j.avsg.2011.07.005.
15. Silver FL, Mackey A, Clark WM, et al. Safety and stenting and endarterectomy by symptomatic status in the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST). Stroke 2011;42(3):675–80. doi: 10.1161/STROKEAHA.110.610212.
16. Hobson RW, Howard VJ, Roubin GS, et al. Carotid artery stenting is associated with increased complications in octogenarians: 30-day stroke and death rates in the CREST lead-in phase. J Vasc Surg 2004;40(6):1106–11.
17. Howard JV, Voeks JH, Lutsep HL, et al. Does sex matter? Thirty-day stroke and death rates after carotid artery stenting in women versus men. Results from the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) lead-in phase. Stroke 2009;40(4):1140–7. doi: 10.1161/STROKEAHA.108.541847.
18. Lam RC, Lin SC, DeRubertis B, et al. The impact of increasing age on anatomic factors affecting carotid angioplasty and stenting. J Vasc Surg 2007;45(5):875–80.
19. Přibáň V, Fiedler J, Baránková L, et al. Komplementarita stentingu a endarterektomie karotid: tříleté zkušenosti. Cesk Slov Neurol N 2008;71/104(1):75–80.
20. Beneš V, Netuka D, Charvát F, et al. Srovnání karotické endarterektomie a stentingu – výsledky jednoho pracoviště. Cesk Slov Neurol N 2008;71/104(4):400–4.
21. Wang FW, Esterbrooks D, Kuo YF, et al. Outcomes after carotid artery stenting and endarterectomy in the Medicare population. Stroke 2011;42(7):2019–25. doi: 10.1161/STROKEAHA.110.608992.
22. Setacci C, Chisci E, Setacci F, et al. Siena carotid artery stenting score. A risk modelling study for individual patients. Stroke 2010;41(6):1259–65. doi: 10.1161/STROKEAHA.110.578583.
23. Arquizan C, Trinquart L, Touboul PJ, et al. Restenosis is more frequent after carotid stenting than after endarterectomy. Stroke 2011;42(4):1015–20. doi: 10.1161/STROKEAHA.110.589309.
24. Lal BK, Breach KW, Roubin GS, et al. Restenosis after carotid artery stenting and endarterectomy: a secondary analysis of CREST, a randomized controlled trial. Lancet Neurol 2012;11(9):755–63.
25. Lanzino G, Burrows AM, Tymianski M. Advances in stroke. Vascular neurosurgery. Stroke 2013;44(2):316–7. doi: 10.1161/STROKEAHA.111.000385.
26. Wholey MH, Wholey M, Mathias K, et al. Global experience in cervical carotid artery stent placement. Catheter Cardiovasc Intervent 2000;50(2):160–7.
27. van Lammeren GW, Peeters W, de Vries JP, et al. Restenosis after carotid surgery. The importance of clinical presentation and preoperative timing. Stroke 2011;42(4):965–71. doi: 10.1161/STROKEAHA.110.603746.
28. Brott TG, Halperin JL, Abbara S, et al. 2011 ASA/ ACCF/ AHA/ AANN/ AANS/ ACR/ ASNR/ CNS/ SAIP/ SCAI/ SIR/ SNIS/ SVM/ SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: a report of the American College of Cardiology Foundation; American Heart Association Task Force on Practice Guidelines; American Stroke Association; American Association of Neurological Surgeons; American College of Radiology; American Society of Neuroradiology; Congress of Neurological Surgeons; Society of Atherosclerosis Imaging and Prevention; Society for Cardiovascular Angiography and Interventions; Society of Interventional Radiology; Society of NeuroInterventional Surgery; Society for Vascular Medicine; Society for Vascular Surgery; American Academy of Neurology; Society of Cardiovascular Computed Tomography. J Am Coll Cardiol 2011;57(8):1002–44. doi: 10.1016/j.jacc.2010.11.005.
29. Carotid artery stenting for symptomatic extracranial carotid stenosis, consultation document National Institute for Health and Clinical Excellence. [online]. Available from URL: http://www.nice.org.uk/guidance/index.jsp?action=article&o-52289.
30. Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack. A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014;45(7):2160–236. doi: 10.1161/STR.0000000000000024.
31. Paraskevas KI, Mikhailidis DP, Veith FJ. Comparison of the five 2011 guidelines for the treatment of carotid stenosis. J Vasc Surg 2012;55(5):1504–8. doi: 10.1016/j.jvs.2012.01.084.
32. Furie KL, Kasner SE, Adams RJ, et al. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack. A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2011;42:227–76. doi: 10.1161/STR.0b013e3181f7d043.
33. Gröschel K, Knauth M, Ernemann U. Early treatment after a symptomatic event is not associated with an increased risk of stroke in patients undergoing carotid stenting. Eur J Neurol 2008;15(1):2–5.
34. Rantner B, Goebel G, Bonati LH. The risk of carotid artery stenting compared with carotid endarterectomy is greatest in patients treated within 7 days of symptoms. J Vasc Surg 2013;57(3):619–26. doi: 10.1016/j.jvs.2012.08.107.
Štítky
Paediatric neurology Neurosurgery NeurologyČlánok vyšiel v časopise
Czech and Slovak Neurology and Neurosurgery
2016 Číslo 3
- Memantine Eases Daily Life for Patients and Caregivers
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Advances in the Treatment of Myasthenia Gravis on the Horizon
- Metamizole vs. Tramadol in Postoperative Analgesia
Najčítanejšie v tomto čísle
- Sympathetic Chain Schwannoma – a Case Report
- Clinical Guideline for the Diagnostics and Treatment of Patients with Ischemic Stroke and Transitory Ischemic Attack – Version 2016
- Validity Study of the Boston Naming Test Czech Version
- Pre-motor and Non-motor Symptoms of Parkinson’s Disease – Taxonomy, Clinical Manifestation and Neuropathological Correlates