Document Detail


Procedure complications of carotid angioplasty and stent placement without cerebral protection devices.
MedLine Citation:
PMID:  15669795     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The goal in this retrospective study was to examine the procedural complication rate for carotid angioplasty and stent placement performed without cerebral protection devices. METHODS: Between March 1996 and December 2003, 167 carotid angioplasty and/or stent placement procedures were performed without cerebral protection devices in 152 patients (57 women and 95 men whose mean age was 64 years, range 19-92 years). Seven of these patients underwent angioplasty alone. Eighty-nine patients presented with focal neurological symptoms. Indications for surgery included atherosclerosis, radiation-associated stenosis, dissection, pseudoaneurysm, and stretched endovascular coils from aneurysm treatment. In this study, the patients' medical records were reviewed for clinical characteristics, techniques used, and resulting intraprocedural and 30-day complication rates. The intraprocedural stroke rate was four (2.4%) of 167; this included three hemispheric strokes and one retinal embolus. All events occurred in patients who had symptomatic stenosis. The procedural transient ischemic complication rate was six (3.6%) of 167, as was the procedural nonneurological complication rate. During the 30 days postprocedure, one patient had died and three had suffered permanent ischemic events (two cerebral and one ocular). The composite 30-day postprocedural stroke and death rate was eight (5%) of 160. The rate of asymptomatic angiographically confirmed abnormalities was 0.6% (one treated vessel that was occluded but asymptomatic). The 30-day rate of nonneurological complications was 2.5%. A strong association between intraprocedural thromboembolic events (eight cases) and prior ischemic symptoms was found (p = 0.01). CONCLUSIONS: Carotid angioplasty and stent placement without cerebral protection devices is safe, particularly in patients without symptomatic stenosis.
Authors:
Yasha Kadkhodayan; Colin P Derdeyn; DeWitte T Cross; Christopher J Moran
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2005-01-15
Journal Detail:
Title:  Neurosurgical focus     Volume:  18     ISSN:  1092-0684     ISO Abbreviation:  Neurosurg Focus     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-01-26     Completed Date:  2006-01-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100896471     Medline TA:  Neurosurg Focus     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e1     Citation Subset:  IM    
Affiliation:
Department of Neurology, Interventional Neuroradiology Service, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angioplasty, Balloon / adverse effects,  methods*
Carotid Artery, Internal / pathology*
Carotid Stenosis / pathology,  therapy*
Female
Humans
Male
Middle Aged
Retrospective Studies
Stents / adverse effects
Stroke / pathology,  prevention & control*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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