Risk factors for peri-procedural stroke or death in internal carotid artery stenting: A neurology team experience

dc.contributor.authorGörgülü, Ümit
dc.contributor.authorDönmez, Recep
dc.contributor.authorArlı, Berna
dc.contributor.authorOrhan, Gürdal
dc.date.accessioned2024-04-19T13:28:58Z
dc.date.available2024-04-19T13:28:58Z
dc.date.issued2023
dc.departmentTıp Fakültesi
dc.description.abstractSuitable cases of extracranial internal carotid artery (ICA) stenosis can be treated with carotid artery stenting (CAS) or carotid endarterectomy. However, major complications in the peri-procedural period, like stroke and death, are more common with CAS. We therefore investigated the risk factors for stroke and death during the peri-procedural period following CAS. Methods: In this study, the files of patients who were treated with CAS by a neurology team during 2020–2022 were retrospectively analyzed. Patient age, gender, vascular risk factors, use of antiplatelet therapy, type of carotid artery stenosis (symptomatic or asymptomatic), measured stenosis degrees, contralateral carotid stenosis, types of aortic arch, balloon angioplasty, use of a filter-type embolism protection device, stent cell design (open or closed), and peri-procedural death, stroke, or myocardial infarction (MI) were recorded. All patients were followed up for the first 30 days after CAS. Results: The mean age of 219 patients included in our study was 67.8 ± 8.38 years and 68.5% were male. The most common comorbid diseases in the patients were hypertension (76.7%), hyperlipidemia (53.4%) and diabetes mellitus (DM) (43.4%). Stroke or death occurred in the peri-procedural period in 15 (6.85%) of the patients, but MI did not occur. No statistically significant difference was observed in terms of age or gender when comparing with the cases without stroke or death. Of the patients suffering stroke or death, ischemic stroke developed in 13 (86.67%), cerebral hemorrhage in two (13.33%) and two patients (13.33%) died. Two-thirds of the strokes were either minor (n=7, 46.67%) or moderate (n=4, 26.67%); 13 (86.67%) were ipsilateral, and 14 (93.33%) were in the anterior circulation. The complication risk was found to be significantly higher in patients with prior stroke (OR=3.865; 95% CI 1.282 to 11.652 p=.016), DM (OR=3.634; 95% CI 1.102 to 11.992 p=.034) and pre-dilation angioplasty (OR=13.100; 95% CI 1.762 to 97.422 p=.012). Conclusion: Prior stroke, DM and pre-dilation angioplasty increase peri-procedural stroke and death in CAS. However, even if a stroke complication develops after CAS, it is often not severe.
dc.description.sponsorshipCarotid artery stenting; death; myocardial infarction; peri-procedural risk factors; stroke
dc.identifier.doi10.54029/2023rhu
dc.identifier.endpage884en_US
dc.identifier.issn1823-6138
dc.identifier.issue4en_US
dc.identifier.scopusqualityQ4
dc.identifier.startpage877en_US
dc.identifier.urihttps:/dx.doi.org10.54029/2023rhu
dc.identifier.urihttps://hdl.handle.net/20.500.12451/11668
dc.identifier.volume28en_US
dc.indekslendigikaynakScopus
dc.language.isoen
dc.publisherASEAN Neurological Association
dc.relation.ispartofNeurology Asia
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectCarotid Artery Stenting
dc.subjectDeath
dc.subjectMyocardial Infarction
dc.subjectPeri-procedural Risk Factors
dc.titleRisk factors for peri-procedural stroke or death in internal carotid artery stenting: A neurology team experience
dc.typeArticle

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