Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Mar 25;11(1):15-24.
doi: 10.3400/avd.ra.17-00136.

Predictors of Perioperative Stroke/Death after Carotid Artery Stenting: A Review Article

Ali F AbuRahma  1
Affiliations
Review

Predictors of Perioperative Stroke/Death after Carotid Artery Stenting: A Review Article

Ali F AbuRahma. Ann Vasc Dis. .

Abstract

Carotid artery stenting (CAS) has been recommended as an alternative treatment to carotid endarterectomy for patients with significant carotid stenosis. Only a few studies have analyzed clinical/anatomical and technical variables that affect perioperative outcomes of CAS. Following a comprehensive Medline search, it was reported that clinical factors, including age of >80 years, chronic renal failure, diabetes mellitus, symptomatic indications, and procedures performed within 2 weeks of transient ischemic attack symptoms, are associated with high perioperative stroke and death rates. They also highlighted that angiographic variables, e.g., ulcerated and calcified plaques, left carotid intervention, >90% stenosis, >10-mm target lesion length, ostial involvement, type III aortic arch, and >60°-angulated internal carotid and common carotid arteries, are predictors of increased stroke rates. Technical factors associated with increased perioperative risk of stroke include percutaneous transluminal angioplasty (PTA) without embolic protection devices, PTA before stent placement, and the use of multiple stents. This review describes the most widely quoted data in defining various predictors of perioperative stroke and death after CAS. (This is a review article based on the invited lecture of the 45th Annual Meeting of Japanese Society for Vascular Surgery.).

Keywords: carotid artery stenting; perioperative death; perioperative stroke.

PubMed Disclaimer

Figures

None
Fig. 1 Distribution of lesion length (in mm) in this series.
See this image and copyright information in PMC

References

    1. Yadav JS, Wholey MH, Kuntz RE, et al. Protected carotid artery stenting versus endarterectomy in high-risk patients. N Engl J Med 2004; 351: 1493-501. - PubMed
    1. Gray WA, Yadav JS, Verta P, et al. The CAPTURE registry: predictors of outcomes in carotid artery stenting with embolic protection for high surgical risk patients in the early post-approval setting. Catheter Cardiovasc Interv 2007; 70: 1025-33. - PubMed
    1. Khan M, Qureshi A. Factors associated with increased rates of post-procedural stroke or death following carotid artery stent placement: a systematic review. J Vasc Interv Neurol 2014; 7: 11-20. - PMC - PubMed
    1. Aronow HD, Gray WA, Ramee SR, et al. Predictors of neurological events associated with carotid artery stenting in high-surgical-risk patients. Circ Cardiovasc Interv 2010; 3: 577-84. - PubMed
    1. Chaturvedi S, Matsumura JS, Gray W, et al. Carotid artery stenting in octogenarians: periprocedural stroke risk predictor analysis from the multicenter Carotid ACCULINK/ACCUNET Post Approval Trial to Uncover Rare Events (CAPTURE 2) clinical trial. Stroke 2010; 41: 757-64. - PubMed

LinkOut - more resources