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Title:
Early and long-term complications of neuroprotected carotid artery stenting
Author:
Subject:
carotid artery stenting ; complications
Abstract:
Aim: To evaluate types and frequency of early and long-term carotid artery stenting (CAS) complications, to identity risk factors of CAS. To evaluate survival, stroke and restenosis rate during follow-up, to identity relevant risk factors. Material and methods: Within the prospective registry, 607 consecutive patients (age 36-88 y.o., 51% symptomatic, 650 CAS procedures), were included. All CAS procedures were conducted according ‘tailored-CAS’ algorithm. Death, stroke and myocardial infarction were considered as major complications. Results: 30-day major complication rate was 2.6%, and it was higher in symptomatic patients group. Hyperperfusion syndrome occurred after 7 (1.1%) CAS procedures. In 2 (0.3%) patients hyperperfusion syndrome led to intracranial bleeding and death. The risk factors of 30-day death were age >75y.o., the use of open-cell stents and treated carotid artery stenosis degree. During long-term follow-up freedom from death rate was 96.5% at 1 year and 86.9% at 5 years. The risk factors for death were coronary artery disease, age and diabetes. Freedom from stroke and restenosis rate were 92.5% and 94.7% at 5 years, respectively. The in-stent restenosis was successfully treated with balloon angioplasty. In case of recurrent restenosis, drug-eluting stent implantation was effective. No risk factors of stroke were found. Contralateral carotid artery stenosis/occ ; lusion was a risk factor of restenosis. (p=0.036). Conclusions: The incidence of major complications is low (2.6%). The most dangerous complication of CAS is hyperperfusion syndrome. During long-term follow-up, freedom from death, stroke and restenosis rates were high.
Place of publishing:
Level of degree:
Degree discipline:
neurologia ; choroby układu krażenia