Carotid artery stenting of a contralateral occlusion and in-hospital outcomes: results from the CARE (Carotid Artery Revascularization and Endarterectomy) registry.
Carotid artery stenting of a contralateral occlusion and in-hospital outcomes: results from the CARE (Carotid Artery Revascularization and Endarterectomy) registry.
复制标题
对侧闭塞的颈动脉支架置入术和院内结果：来自 CARE（颈动脉血运重建和动脉内膜切除术）登记处的结果。
DOI：
10.1016/j.jcin.2012.09.009
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Marso,StevenP
中科院分区：
文献类型：
--
作者：
Mercado,Nestor;Cohen,DavidJ;Spertus,JohnA;Chan,PaulS;House,John;Kennedy,Kevin;Brindis,RalphG;White,ChristopherJ;Rosenfield,KennethA;Marso,StevenP
BackgroundContralateral carotid artery occlusions (CCO) are associated with adverse neurologic events following carotid endarterectomy (CEA). The characteristics and outcomes of patients with CCO undergoing elective carotid artery stenting (CAS) have not been completely studied.MethodsIn-hospital outcomes were examined in patients with and without CCO undergoing elective CAS in the Carotid Artery Revascularization and Endarterectomy (CARE Registry®). A CCO was defined as a 100% occlusion of the contralateral internal carotid artery. The primary endpoint was a composite of in-hospital death, nonfatal myocardial infarction, and nonfatal stroke.ResultsBetween 2005 and 2010, 8,416 patients underwent elective CAS, of whom 900 (12%) had CCO. Patients with CCO were younger (69 vs. 71 years, p<0.001), more often male (68% vs. 61%, p<0.001), more frequently had symptoms due to the target lesion (46% vs. 39%, p<0.001), had a prior neurologic event (56% vs. 45%, p<0.001), and more frequently had restenosis in a target lesion after previous CAS (5% vs. 3%, p<0.001). The primary composite endpoint occurred in 14 (1.6%) and 211 (2.8%) patients with and without CCO, respectively (adjusted OR 0.58, 95% CI 0.33-1.00, p=0.052).ConclusionIn the CARE registry, there was no evidence that the presence of a CCO was associated with an increased risk of in-hospital death, non-fatal myocardial infarction or stroke in patients undergoing elective carotid artery stenting. These findings may have implications on the selection of carotid revascularization procedures for such patients.
