| Carotid artery stenting: identification of risk factors for poor outcomes. | |
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MedLine Citation:
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PMID: 18502085 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Age greater than 80 has been identified as a risk factor for complications, including stroke and death, in patients undergoing carotid artery angioplasty and stenting (CAS). This study evaluates other potential predictors of perioperative complications in patients undergoing CAS. METHODS: All cerebrovascular endovascular procedures performed by the vascular surgery division at our university hospital between July 2003 and December 2005 were retrospectively examined. During the course of 212 admissions, 198 patients underwent 215 procedures. Patient age, comorbidities, and admission status were analyzed as independent (predictor) variables. Complication rate, discharge disposition, and length of hospital stay were considered dependent (outcome) variables. Logistic regression and Fisher exact test or Student t test were performed, as appropriate. RESULTS: Complications included major and minor stroke, myocardial infarction, femoral artery pseudoaneurysm, and death. The rates of perioperative major and minor stroke were 0.5% and 2.8%, respectively. Chronic renal insufficiency was a predictor of perioperative complications, including stroke: patients with serum creatinine greater than 1.3 mg/dL had a 37% complication rate and a 11.1% stroke rate, while those with normal renal function had a 13% complication rate (P = .003) and a 0.6% stroke rate (P =.001). Similar association was seen between creatinine clearance and both stroke and complications. Obesity was a risk factor for complications, but not stroke: obese patients had a complication rate of 28%, while others had a 16% complication rate (P = .024). Emergency admission predicted both extended hospital stay (P < .001) and requirement for further inpatient care in a rehabilitation or nursing facility (P = .007). There was no significant difference in complication rate or stroke rate between octogenarians and others. CONCLUSION: This experience demonstrates that chronic renal insufficiency, obesity, and emergent clinical setting are risk factors for patients undergoing CAS. |
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Authors:
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Benjamin M Jackson; Sean J English; Ronald M Fairman; Jagajan Karmacharya; Jeffrey P Carpenter; Edward Y Woo |
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Publication Detail:
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Type: Journal Article Date: 2008-05-23 |
Journal Detail:
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Title: Journal of vascular surgery Volume: 48 ISSN: 0741-5214 ISO Abbreviation: J. Vasc. Surg. Publication Date: 2008 Jul |
Date Detail:
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Created Date: 2008-06-30 Completed Date: 2008-08-29 Revised Date: 2012-10-03 |
Medline Journal Info:
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Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 74-9 Citation Subset: IM |
Affiliation:
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Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA. benjamin.jackson@uphs.upenn.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Balloon* Carotid Stenosis / epidemiology, therapy* Emergency Medical Services Endarterectomy, Carotid Female Humans Male Middle Aged Multivariate Analysis Obesity / epidemiology Renal Insufficiency, Chronic / epidemiology Risk Factors Stents* Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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