Effect of high-dose strong statin for preventing periprocedural ischemic complications of carotid artery stenting

• Published in: Heart and vessels 2020-06, Vol.35 (6), p.762-768
• Main Authors: Shinozaki, Norihiko, Murakami, Tsutomu, Ohno, Yohei, Nakano, Masataka, Fujii, Toshiharu, Nakazawa, Gaku, Yoshimachi, Fuminobu, Ikari, Yuji
• Format: Article
• Language: English
• Subjects: Aged; Arteriosclerosis; Atherosclerosis; Atorvastatin; Atorvastatin - administration & dosage; Atorvastatin - adverse effects; Biomedical Engineering and Bioengineering; Brain Ischemia - diagnostic imaging; Brain Ischemia - etiology; Brain Ischemia - prevention & control; Cardiac Surgery; Cardiology; Carotid arteries; Carotid artery; Carotid Artery Diseases - complications; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - therapy; Complications; Diffusion Magnetic Resonance Imaging; Drug Administration Schedule; Endovascular Procedures - adverse effects; Endovascular Procedures - instrumentation; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage; Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects; Ischemia; Lesions; Magnetic resonance imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Regression analysis; Retrospective Studies; Risk Factors; Rosuvastatin Calcium - administration & dosage; Rosuvastatin Calcium - adverse effects; Statins; Stents; Stroke - diagnostic imaging; Stroke - etiology; Stroke - prevention & control; Time Factors; Treatment Outcome; Vascular Surgery
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-019-01552-5

Statin therapy has been shown to induce carotid atherosclerotic plaque regression and reduce the periprocedural ischemic complications of carotid artery stenting (CAS). This study assessed the safety and usefulness of pretreatment using a high-dose strong statin (HDSS) to reduce the periprocedural ischemic complications of CAS. We analyzed 117 carotid lesions treated by CAS that were evaluated with magnetic resonance imaging (MRI) within 48 h after the procedure. For 67 lesions, an HDSS (rosuvastatin 20 mg or atorvastatin 40 mg daily) were prescribed from at least 14 days before CAS to at least 14 days after procedure (HDSS group). Clinical and angiographic data, as well as in-hospital outcomes, of the HDSS group were retrospectively compared with 50 lesions with conventional treatment without an HDSS (non-HDSS group). There were no significant differences in the baseline clinical and procedural characteristics between the two groups. There was no side effect related to the HDSS. Stroke rates were similar between the two groups (3.0% in HDSS group vs 8.0% in non-HDSS group, p  = 0.22). All were minor strokes. Compared to the non-HDSS group, the HDSS group had a lower frequency of new lesions on diffusion-weighted imaging (DWI) with MRI (25.4% vs 44.0%, p  = 0.0345). New ipsilateral DWI-positive rate in the HDSS group was significantly lower than in the non-HDSS group (16.4% vs 34.0%, p  = 0.0275). Nonipsilateral (contralateral or posterior circulation) DWI-positive rates were similar between the two groups (13.4% vs 20.0%, p  = 0.34). Pretreatment with an HDSS might reduce the periprocedural ischemic complications of CAS.