Document Detail


Carotid artery stenting: identification of risk factors for poor outcomes.
MedLine Citation:
PMID:  18502085     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Benjamin M Jackson; Sean J English; Ronald M Fairman; Jagajan Karmacharya; Jeffrey P Carpenter; Edward Y Woo
Related Documents :
19687705 - Quantitative analysis of adverse events in neurosurgery.
3578615 - Geographic variations in elderly hospital and surgical discharge rates, new york state.
21477535 - Data-driven disaster management requires data: implementation of a military orthopaedic...
19517055 - Factors influencing infectious complications after pancreatoduodenectomy.
3171365 - Auditory brain stem responses (abr) in patients with acute severe closed head injuries....
9617415 - Acute achilles tendon rupture in badminton players.
Publication Detail:
Type:  Journal Article     Date:  2008-05-23
Journal Detail:
Title:  Journal of vascular surgery     Volume:  48     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-30     Completed Date:  2008-08-29     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  74-9     Citation Subset:  IM    
Affiliation:
Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA. benjamin.jackson@uphs.upenn.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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


Previous Document:  Infrapopliteal angioplasty for critical limb ischemia: relation of TransAtlantic InterSociety Consen...
Next Document:  Prolonged increases in vein wall tension increase matrix metalloproteinases and decrease constrictio...