Outcomes of Carotid Artery Stenting in Elderly Patients: A Single Center Retrospective Study: the Effect of Post-dilatation on Outcomes

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Küçük Resim

Tarih

2021

Dergi Başlığı

Dergi ISSN

Cilt Başlığı

Yayıncı

Ortadoğu Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S.

Erişim Hakkı

info:eu-repo/semantics/openAccess

Özet

Objective: Carotid artery stenting (CAS) is a current treatment approach that has been applied in symptomatic and asymptomatic carotid artery stenosis. In addition to being a minimally invasive method, it has fewer complications and mortality rates, and short hospital stays when compared to carotid endarterectomy. Some studies showed that the risk of stroke or death twice as high after CAS than after carotid endarterectomy among those ?70 years old. In this study, we aimed to investigate the short- and long-term complications, efficacy, and durability of CAS in elderly patients (?70 years old) with carotid artery stenosis with a median follow-up of 5.08 years (interquartile range 3.2-8.1), respectively. Material and Methods: A total of 140 patients who underwent CAS due to atherosclerotic carotid artery stenosis were included in the study. Stroke rates (total n=15[10.7%], n=3[5%] vs n=12[15%], p=0.049) were higher in patients who were ?70 years of age during the follow-up. The two groups (the group with age <70 and the group with age ?70) were compared according to demographic, biochemical data, and clinical outcomes such as stroke and stroke/death. Results: According to multivariate logistic regression analysis, those who were ?70 years, those with a history of earlier stroke, and the patients requiring post-dilatation were at risk of recurrent stroke. Deaths occurred in 5 of 140 patients in the follow-up. The patients who were ?70 years (OR 4.577 [95% CI=1.023-5.544], p=0.043), who have a history of earlier stroke (OR=6.965 [95% CI=1.067-13.115], p=0.038), and those requiring post-dilatation (OR=2.312 [95%CI=1.156-5.775], p=0.022) were at risk of recurrent stroke. Only age ?70 years (OR=4.577 [95% CI=1.210-17.191], p=0.024) was an important risk factor for death/stroke. Conclusion: Although the immediate results of the CAS procedure in patients with age ?70, were successful, they, especially in those with a history of earlier stroke and those requiring post-dilation, had a higher risk of stroke and the combined endpoint of death/stroke in the follow-up. Copyright © 2021 by Türkiye Klinikleri.

Açıklama

Anahtar Kelimeler

Carotid arteries, Death, Stents, Stroke, acetylsalicylic acid plus clopidogrel, contrast medium, heparin, adult, aged, Article, balloon dilatation, bolus injection, bradycardia, brain damage, brain hemorrhage, carotid artery obstruction, carotid artery stenting, carotid atherosclerosis, cerebral hyperperfusion syndrome, cerebrovascular accident, cerebrovascular disease, clinical outcome, comparative study, computer assisted tomography, controlled study, data analysis software, demography, diabetes mellitus, disease severity, Doppler flowmetry, female, follow up, geriatric patient, heart infarction, high risk patient, human, hyperlipidemia, hypertension, hypotension, ischemic heart disease, major clinical study, male, medical history, medical record review, middle aged, mortality rate, multivariate logistic regression analysis, obesity, recurrent disease, retrospective study, risk factor

Kaynak

Turkiye Klinikleri Cardiovascular Sciences

WoS Q Değeri

Scopus Q Değeri

Q4

Cilt

33

Sayı

1

Künye