The 10-year Trend of Periprocedural Complication Following Carotid Artery Stenting; Single Center Experience

• Published in: Cardiovascular and interventional radiology 2015-04, Vol.38 (2), p.280-287
• Main Authors: Hong, Jeong-Ho, Kang, Jihoon, Yeo, Min-Ju, Kim, Beom Joon, Jang, Min Uk, Bae, Hee-Joon, Kwon, O-Ki, Hwang, Gyo Jun, Oh, Chang Wan, Jung, Cheolkyu, Lee, Ji Sung, Han, Moon-Ku
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; AUGMENTATION; Cardiology; CAROTID ARTERIES; Carotid Stenosis - epidemiology; Carotid Stenosis - surgery; Causality; Clinical Investigation; CLINICAL TRIALS; Comorbidity; COMPARATIVE EVALUATIONS; DEATH; Female; Follow-Up Studies; HOSPITALS; Humans; Imaging; LIPIDS; Male; MALES; Medicine; Medicine & Public Health; Middle Aged; MYOCARDIAL INFARCTION; Myocardial Infarction - epidemiology; Nuclear Medicine; PATIENTS; Postoperative Complications - epidemiology; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; Risk Factors; Stents; Stroke - epidemiology; Treatment Outcome; Ultrasound; Young Adult
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-014-0917-y

Purpose Carotid endarterectomy and stenting are used to treat carotid stenosis, with the volume of carotid artery procedures increasing over the past decade. We investigated the 10-year trend of periprocedural complications with an increasing procedure volume of carotid stenting at a single tertiary hospital. Methods We collected 416 consecutive cases (384 patients) of carotid artery stenting performed for either symptomatic (231 cases, 55.5 %) or asymptomatic (185 cases, 44.5 %) internal carotid artery stenosis at a single center. Periprocedural complication was defined as any stroke, myocardial infarction, or death. Procedure-related outcome included any dissection, hemodynamic event, or periprocedural complication. Results The mean age was 68.8 years (82.8 % males; range of 20–89 years); 23.9 % were older than 75 years. Before the procedure, 99.3 and 56.0 % of patients received antiplatelet and lipid-lowering medication, respectively. The overall periprocedural complication rate was 3.6 % (1.6 and 5.2 % in the asymptomatic and symptomatic group, respectively). The composite outcome of any stroke or death was 3.4 %. Periprocedural complication and procedure-related outcome showed a decremental trend with increasing procedure volume, and this trend remained after adjusting for confounders. Conclusions Our study suggests that carotid stenting at an experienced center might reduce the periprocedural complications. Our periprocedural complication rate of carotid artery stenting may be comparable to, or somewhat lower than, that reported in other clinical trials.