J Cerebrovasc Endovasc Neurosurg.  2019 Jun;21(2):86-93. 10.7461/jcen.2019.21.2.86.

Neurologic complications in patients with carotid artery stenting

Affiliations
  • 1Department of Neurosurgery, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Korea. jjongse@hanmail.net

Abstract


OBJECTIVE
Carotid artery stenting is helpful in patients with carotid artery stenosis and is a common method of treatment. However, data on the neurological consequences that might arise from, especially Asian patients after CAS is not enough. The purpose of this study was to investigate the outcome and prognostic factors affecting CAS patients.
METHODS
From January 2013 to June 2018 it was enrolled 97 patients who underwent CAS with severe carotid artery stenosis in a single institution. We retrospectively reviewed neurologic complications such as restenosis, ipsilateral or contralateral stroke, and hyperperfusion during the 6-month follow-up period.
RESULTS
There were no complication occured during the procedure in all 97 patients. Neurologic complications occurred in 30 patients (30.9%) after the procedure, and ipsilateral stroke 6 (6.2%), contralateral stroke 9 (9.4%), restenosis 2 (2.1%) and hyperperfusion 13 respectively. One of them had died (1.0%), of which the rest were discharged after symptoms improve. On univariate analysis, DM and pre-op NIHSS score was associated with the risk of CAS complication, exclusively. On the binary logistic regression for risk factors, DM (OR 0.144, 95% CI [0.029-0.718]), history of radiotheraphy (OR 36.103, 95% CI [1.009-1291.789]) and preoperative NIHSS (OR 1.266, 95% CI [1.059-1.513]) showed independent risk factors associated with post procedural neurological complications, statistically.
CONCLUSION
Carotid artery stenting is a relatively safe and reliable long-term outcome for patients with carotid artery stenosis. However, careful observation should be taken after procedure immediately for any possible complications.

Keyword

Carotid Stenosis; Stents; Endovascular Procedures; Postoperative Complications

MeSH Terms

Asian Continental Ancestry Group
Carotid Arteries*
Carotid Stenosis
Endovascular Procedures
Follow-Up Studies
Humans
Logistic Models
Methods
Postoperative Complications
Retrospective Studies
Risk Factors
Stents*
Stroke

Figure

  • Fig. 1 A 79-year-old male was admitted for left side weakness due to right border zone infarction (A). After performing digital subtraction angiography, he was diagnosed with a 78.4% stenosis of the right internal carotid artery (B). He underwent right CAS procedure without periprocedural complication (C). Three hours following CAS, a computerized tomography of the brain reveals a large right-hemisphere hematoma, with midline shift and intraventricular hemorrhage (D).


Cited by  2 articles

Carotid Artery Angioplasty and Stenting for Carotid Stenosis: A Single-Center Experience from Saudi Arabia
Hussein Algahtani, Bader Shirah, Abdullah S. Alghamdi, Ahmad Subahi, Saeed A. Alqahtani, Abdulrahman Alshamy
Neurointervention. 2020;15(3):133-139.    doi: 10.5469/neuroint.2020.00052.

Long-term outcomes of carotid artery stenting in patients with carotid artery stenosis: A single-center 14-year retrospective analysis
Beom Mo Kang, Seok Mann Yoon, Jae Sang Oh, Hyuk Jin Oh, Jae Min Ahn, Gi Yong Yun
J Cerebrovasc Endovasc Neurosurg. 2023;25(2):160-174.    doi: 10.7461/jcen.2023.E2022.07.007.


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