Carotid artery stenting: Do procedural complications relate to the side intervened upon?
Identifieur interne : 000F00 ( Main/Curation ); précédent : 000E99; suivant : 000F01Carotid artery stenting: Do procedural complications relate to the side intervened upon?
Auteurs : Ralf Zahn [Allemagne] ; Thomas Ischinger ; Matthias Hochadel [Allemagne] ; Bernd Mark [Allemagne] ; Uwe Zeymer [Allemagne] ; Wolfgang Schmalz ; Alexander Schramm ; Karl Eugen Hauptmann ; Hubert Seggewi ; Ilse Janicke ; Harald Mudra ; Jochen Senges [Allemagne]Source :
- Catheterization and Cardiovascular Interventions [ 1522-1946 ] ; 2009-07-01.
English descriptors
Abstract
Objectives: To determine the influence of the side intervened upon on outcomes during carotid artery stenting (CAS). Background: Anatomic and technical aspects may influence the results of CAS. The value of the side intervened upon has not been analyzed yet. Methods: We analyzed data from the Carotid Artery Stent (CAS) – Registry. Results: A total of 3,165 CAS procedures, 1,613 (51%) at the left and 1,552 (49%) at the right carotid artery were included. There was a higher proportion of patients treated for symptomatic stenoses when CAS was performed at the left carotid artery (50.1% versus 45.8%, P = 0.016) and more patients already had prior carotid endarterectomy (8.5% versus 5.8%, P = 0.003). Interventions at the left side took 3 min longer than interventions at the right side (46.6 ± 24.3 versus 43.8 ± 23.6, P = 0.003). In patients treated at the left carotid artery amaurosis fugax (0.7% versus 0.1%, P = 0.005), ipsilateral stroke (3.1% versus 1.8%, P = 0.017), and the primary endpoint of in‐hospital death or stroke (4.1% versus 2.3%, P = 0.005) occurred significantly more often. Even after adjusting for confounding parameters, CAS procedures performed at the left carotid arteries remained an independent predictor of death or stroke (OR = 1.77, 95% CI: 1.15–2.72, P = 0.009). Conclusions: In current clinical practice, CAS is performed frequently at the right carotid artery as at the left carotid artery. CAS interventions have a higher in‐hospital complication rate if performed at the left carotid artery. Technical improvements might help to overcome this situation. © 2009 Wiley‐Liss, Inc.
Url:
DOI: 10.1002/ccd.22050
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Thomas Ischinger<affiliation><wicri:noCountry code="subField">München‐Bogenhausen</wicri:noCountry>
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<affiliation><wicri:noCountry code="subField">Worms</wicri:noCountry>
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<affiliation><wicri:noCountry code="subField">Osnabrück</wicri:noCountry>
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<affiliation><wicri:noCountry code="subField">Trier</wicri:noCountry>
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<affiliation><wicri:noCountry code="subField">Schweinfurt</wicri:noCountry>
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<affiliation><wicri:noCountry code="subField">Duisburg</wicri:noCountry>
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<front><div type="abstract" xml:lang="en">Objectives: To determine the influence of the side intervened upon on outcomes during carotid artery stenting (CAS). Background: Anatomic and technical aspects may influence the results of CAS. The value of the side intervened upon has not been analyzed yet. Methods: We analyzed data from the Carotid Artery Stent (CAS) – Registry. Results: A total of 3,165 CAS procedures, 1,613 (51%) at the left and 1,552 (49%) at the right carotid artery were included. There was a higher proportion of patients treated for symptomatic stenoses when CAS was performed at the left carotid artery (50.1% versus 45.8%, P = 0.016) and more patients already had prior carotid endarterectomy (8.5% versus 5.8%, P = 0.003). Interventions at the left side took 3 min longer than interventions at the right side (46.6 ± 24.3 versus 43.8 ± 23.6, P = 0.003). In patients treated at the left carotid artery amaurosis fugax (0.7% versus 0.1%, P = 0.005), ipsilateral stroke (3.1% versus 1.8%, P = 0.017), and the primary endpoint of in‐hospital death or stroke (4.1% versus 2.3%, P = 0.005) occurred significantly more often. Even after adjusting for confounding parameters, CAS procedures performed at the left carotid arteries remained an independent predictor of death or stroke (OR = 1.77, 95% CI: 1.15–2.72, P = 0.009). Conclusions: In current clinical practice, CAS is performed frequently at the right carotid artery as at the left carotid artery. CAS interventions have a higher in‐hospital complication rate if performed at the left carotid artery. Technical improvements might help to overcome this situation. © 2009 Wiley‐Liss, Inc.</div>
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