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. 2022 Nov;32(6):1161-1169.
doi: 10.1111/jon.13036. Epub 2022 Aug 15.

Early and mid-term outcomes of carotid angioplasty and stent placement in 579 patients

Afshin Borhani-Haghighi  1 , Etrat Hooshmandi  1 , Farzaneh Zahediasl  1 , Hossein Molavi Vardanjani  2 , Mahdiyeh Rezaei  1 , Abbas Rahimi-Jaberi  1 , Nahid Ashjazadeh  1 , Peyman Petramfar  1 , Vahid Reza Ostovan  1 , Nima Fadakar  1 , Maryam Poursadeghfard  1 , Sadegh Izadi  1 , Masoumeh Nazeri  1 , Seyedeh Shaghayegh Zafarmand  1 , Mahnaz Bayat  1 , Mohammad Saied Salehi  1 , Maryam Owjfard  1 , Behnaz Sedighi  3 , Farhad Iranmanesh  3 , Kaveh Shafiei  3 , Alireza Vakilian  4 , Amir Moghadam Ahmadi  5 , Reza Nemati  6 , Fatemeh Rezaeian Jahromi  7 , Maryam Jalalijahromi  7 , Kaveh Kashani  8 , Saeed Razmeh  9 , Mansour Bahrehbar  9 , Marzieh Basir  1 , Adnan I Qureshi  10
Affiliations

Early and mid-term outcomes of carotid angioplasty and stent placement in 579 patients

Afshin Borhani-Haghighi et al. J Neuroimaging. 2022 Nov.

Abstract

Background and purpose: Carotid angioplasty and stenting (CAS) could be considered for preventing stroke in patients with carotid artery stenosis. This study aimed to determine the incidence and the risk factors of the early and mid-term complications associated with CAS.

Methods: This is a retrospective cohort study conducted at Shiraz University of Medical Sciences from March 2011 to March 2019. Patients at high risk and standard risk for carotid endarterectomy were included. The primary composite outcome was defined as stroke, myocardial infarction (MI), and death in the first 30 days after CAS. All-cause mortality, vascular mortality, and stroke were investigated during mid-term follow-up.

Results: A total of 579 patients (618 CAS) were recruited (mean age: 71.52 years). Overall, 394 (68.40%), 211 (36.63%), 179 (31.07%), and 96 (16.72%) patients had hypertension, dyslipidemia, diabetes mellitus, or were cigarette smokers, respectively. Primary composite outcomes were observed in 2.59% of patients (1.55% stroke, 0.69% MI, and 1.72% death). Atrial fibrillation was a predictor of primary composite outcome in multivariate logistic regression (p = .048). The presence of total occlusion in the contralateral carotid artery was significantly associated with the risk of stroke in univariate logistic regression (p = .041). The patients were followed for a period ranging from 1 to 83 months. The overall survival rate for all-cause mortality was 93.48% at 1 year, 77.24% at 5 years, and 52.92% at 8 years. All-cause mortality was significantly higher among patients with symptomatic carotid stenosis (p = .014).

Conclusion: CAS provides acceptable short-term and mid-term outcomes in a unique population of high- and standard-surgical-risk, symptomatic and asymptomatic, octogenarian, and nonoctogenarian patients.

Keywords: angioplasty and stenting; carotid endarterectomy; carotid stenosis; cerebrovascular disease; ischemic stroke; stroke.

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References

REFERENCES

    1. Borhani-Haghighi A, Safari R, Heydari ST, et al. Hospital mortality associated with stroke in southern Iran. Iran J Med Sci. 2013;38:314-20.
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    1. Borhani-Haghighi A, Emami M, Vasaksi AS, et al. Large-vessel stenosis in the patients with ischemic stroke in Iran: prevalence, pattern, and risk factors. J Vasc Interv Neurol. 2015;8:11-6.
    1. Borhani-Haghighi A, Yousefi S, Bahramali E, et al. Demographic and technical risk factors of 30-day stroke, myocardial infarction, and/or death in standard-and high-risk patients who underwent carotid angioplasty and stenting. Interv Neurol. 2015;3:165-73.
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