Document Detail


Outcome evaluation of carotid stenting in high-risk patients with symptomatic carotid near occlusion.
MedLine Citation:
PMID:  20977866     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Management of symptomatic carotid near occlusion especially in high-risk patients is different from outcome analysis of NASCET. We evaluated outcome in high-risk patients with symptomatic near occlusion. For 48 patients with near occlusion out of 166 symptomatic high-risk patients who underwent carotid stenting, we assessed the procedural success defined as residual stenosis <30%, modified Rankin Scale (mRS) at one and six months following stenting, and the 13 cerebrovascular factors related to the outcome. Initial National Institutes of Health Stroke Scale (NIHSS) ≥4, 1-3 and 0 were 13, 14 and 21 patients each. We compared the outcome with patients who underwent CAS (n=118) due to symptomatic stenosis without near occlusion during the same period. Our procedural success rate was 98%. A good outcome (mRS ≤2) was achieved in 44 patients (92%) at six months. There were five events (10%) within six months, i.e. three minor strokes, one major stroke caused by hemorrhage, and one death excluding two deaths not related to stroke. Hyperperfusion (n=4) was the most common cause of events leading to two minor strokes and a major stroke. Although initial NIHSS (P = .012) was related to poor outcome (mRS >2) compared to the CAS group, there was no statistical significance between two groups in the event rate of stroke, death or restenosis. The outcome of carotid stenting in high-risk patients with symptomatic near occlusion did not reveal any difference compared with CAS. Poor outcome was related to the initial NIHSS (≥4). Hyperperfusion tended to be more commonly related to an event occurring after stenting.
Authors:
B S Choi; J W Park; J E Shin; P-H Lü; J K Kim; S J Kim; D H Lee; J S Kim; H J Kim; D C Suh
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-10-25
Journal Detail:
Title:  Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences     Volume:  16     ISSN:  1591-0199     ISO Abbreviation:  Interv Neuroradiol     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-10-27     Completed Date:  2010-12-30     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  9602695     Medline TA:  Interv Neuroradiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  309-16     Citation Subset:  IM    
Affiliation:
Department of Radiology and Research Institute of Radiology, University of Ulsan, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Carotid Stenosis / diagnosis,  epidemiology*,  therapy*
Cerebral Angiography
Cerebral Hemorrhage / epidemiology
Cerebral Revascularization / adverse effects,  methods*,  statistics & numerical data*
Databases, Factual
Diffusion Magnetic Resonance Imaging
Female
Humans
Male
Risk Factors
Severity of Illness Index
Stents*
Treatment Outcome
Comments/Corrections

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