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The interval between carotid artery stenting and open heart surgery is related to perioperative complications
Author(s) -
Dong Hui,
Jiang Xiongjing,
Peng Meng,
Zou Yubao,
Che Wuqiang,
Qian Haiyan,
Xu Bo,
Song Lei,
Yang Yuejin,
Gao Runlin
Publication year - 2016
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.26408
Subject(s) - medicine , stroke (engine) , perioperative , myocardial infarction , carotid stenting , stenosis , heart failure , cardiology , surgery , incidence (geometry) , carotid endarterectomy , mechanical engineering , physics , optics , engineering
Objectives To assess 30‐day outcomes and the optimal interval between carotid artery stenting (CAS) and open heart surgery (OHS). Background Whether or not they show symptoms of carotid atherosclerosis, patients with significant carotid stenosis who underwent OHS face a high risk of perioperative stroke. Planning appropriate treatment for carotid stenosis before OHS has become an important clinical issue. Methods From January 2005 to June 2010, 154 inpatients scheduled for CAS and OHS were recruited and followed up for 30 days after OHS. The primary end point was a composite of major stroke or neurological death. The secondary end points included a composite of major stroke, myocardial infarction (MI) or any death, minor stroke, and acute kidney injury (AKI). Results The incidence of the primary end point, the composite of major stroke, MI or any death, minor stroke and AKI was 3.2%, 5.8%, 2.6%, and 4.5%, respectively. Only an interval between CAS and OHS of ≤5 days could independently predict the incidence of the primary end point (OR, 14.06, 95% CI, 1.52‐130.13; P =0.020). Moreover, congestive heart failure (OR, 7.07, 95% CI, 1.55‐21.27; P =0.012) and an interval between CAS and OHS of ≤5 days (OR, 7.05, 95% CI, 1.58‐31.40; P =0.010) were identified as independent risk factors for the composite of major stroke, MI, or any death. Conclusions Our findings indicate that CAS followed by OHS is safe and feasible. More importantly, an interval between CAS and OHS of >5 days may decrease periprocedural complications, especially major stroke and neurological death. © 2016 Wiley Periodicals, Inc.