Premium
Timing of stenting of symptomatic carotid stenosis is predictive of 30‐day outcome
Author(s) -
Topakian R.,
Strasak A. M.,
Sonnberger M.,
Haring H.P.,
Nussbaumer K.,
Trenkler J.,
Aichner F. T.
Publication year - 2007
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2007.01815.x
Subject(s) - medicine , stenosis , stroke (engine) , carotid stenting , confidence interval , modified rankin scale , odds ratio , cardiology , logistic regression , surgery , ischemia , ischemic stroke , carotid endarterectomy , mechanical engineering , engineering
For patients with symptomatic carotid stenosis, benefit from carotid artery stenting (CAS) highly depends on the 30‐day stroke and death rates. Identification of predictors of unfavourable outcome would help guide the patient selection. We analysed the influence of clinical and angiographic factors on the 30‐day outcomes of 77 consecutive patients who underwent CAS for ≥60% symptomatic carotid stenosis within 180 days of transient ischaemic attack or moderate stroke (modified Rankin Scale score ≤3). The 30‐day composite end‐point for stroke (7.8%) and death of any cause (1.3%) was 9.1%. Patients with complicated CAS were older than patients with uncomplicated CAS (mean age 75.1 ± 8.2 vs. 65.9 ± 9.5 years, P = 0.015) and underwent stenting significantly earlier after the qualifying event: median delay 1.5 weeks (range: 0.2–3.0) vs. 3.2 weeks (range: 0.5–26), P = 0.004. In multivariate logistic regression analyses, age [odds ratio (OR) = 1.148; 95% confidence interval (CI): 1.011–1.304 and P = 0.033] and delay of treatment <2 weeks (OR = 22.399; 95% CI: 2.245–223.445 and P = 0.008) remained the only variables significantly associated with 30‐day outcome. CAS carries a considerable risk in old patients and when performed early (<2 weeks) after the qualifying event. Future reports should address the timing of CAS.