Relationship of Carotid Artery Stenosis Ratio and Perioperative Stent Complications

Year 2023, Volume: 13 Issue: 2, 187 - 196, 30.06.2023

Cigdem Deniz Vildan Güzel Gulistan Halac Muharrem Nasifov Ömer Göktekın Talip Asil

https://doi.org/10.31832/smj.1130202

Abstract

Objective: This study aimed to examine complications that may occur after carotid artery stenting (CAS) and their relationships with carotid artery stenosis rate.
Materials and Methods: Complications, such as cerebral hyperperfusion, stroke, death, stent thrombosis or occlusion and restenosis, were evaluated on the 30th day after CAS and at the end of the first year.
Results: Of the 205 CAS procedures, complications developed in 12 patients. The complication rate for the first 30 days after the procedure was 4,87%, and at the end of the first year, it was 5,85%. Of the 12 patients with complications, 8 had carotid stenosis of ≥90%. Death occurred in 4 of 195 patients with carotid artery stenosis. The mortality rate within the first 30 days and during the 1-year follow-up period was 1,53% and 2,05%, respectively. Ischemic stroke occurred in 6 of 195 patients with carotid artery stenosis. After the first 30 days and one year follow-up, ischemic stroke had occurred in 3,07% of patients. Stent thrombosis and occlusion rate was 4,87% in 205 CAS procedures, and 7 of them occurred in the first 24 hours and another 3 occurred within the first 30 days. Restenosis rates were 0,48% and 0,97% at 6 months and the first year, respectively.
Conclusion: The complications of CAS have been associated with the urgency of treatment (emergency), symptom presence (symptomatic patients) and high degree of stenosis (≥90%); whereas bilateral stenosis is not associated with complications. In addition, stent thrombosis and occlusion were observed as the most common CAS complication.

Keywords

carotid stent, stent complication, carotid artery stenosis, stent thrombosis, stroke

Thanks

We would like to thank Bengu Altunan for English language editing.

Karotid Arter Darlık Oranı ile Perioperatif Stent Komplikasyonları İlişkisi

Abstract

Amaç: Biz bu çalışmada karotid arter stentleme (KAS) sonrası oluşabilecek komplikasyonlar, komplikasyonların karotid arter darlık oranları ile ilişkisini incelemeyi amaçladık.
Gereç ve Yöntemler: Çalışmaya 205 işlem olmak üzere 195 hasta alındı. KAS sonrası ilk 30 günde ve 1 yılda serebral hiperperfüzyon, inme, ölüm, stent trombozu veya oklüzyonu ve restenoz gibi komplikasyonlar değerlendirildi.
Bulgular: 205 KAS işlemde 12 hastada komplikasyon gelişti. 205 KAS işlem sonrası ilk 30 gün için komplikasyon oranı % 4,87 iken, 1. yıl sonunda % 5,85 oranında izlendi. Komplikasyon görülen 12 hastanın 8'inin karotid arterlerinde % 90 ve üzeri darlık mevcuttu. 195 karotid arter hastasının 4’ ünde ölüm gelişti. İlk 30 gün içindeki mortalite oranı % 1,53 iken bir yıllık izlem sürecinde toplam mortalite oranı % 2,05 olarak bulundu. 195 karotid arter hastasının 6’sında iskemik inme saptandı. İlk 30 gün ve bir yıllık takip sonrası iskemik inme oranı % 3,07 olarak saptandı. Stent trombozu ve oklüzyonu oranı 205 KAS işlemde % 4,87 olup, 7’ si ilk 24 saatte, 3’ ü ise ilk 30 gün içinde meydana gelmişti. Restenoz ilk 6 ay sonunda % 0,48 oranında görülürken, bu oran ilk bir yıl sonunda % 0,97 olarak izlendi.
Sonuç:KAS işlem için komplikasyon görülme sıklığının bilateral karotid arter darlığı olan vakalardan çok; darlık oranın yüksek (%90 ve üzeri), acil ve semptomatik vakalarla ilişkili olduğu gözlemlenmiştir. Ayrıca çalışmamızda stent trombozu ve oklüzyonu en sık KAS komplikasyonu olarak tespit edilmiştir.

Keywords

karotid stent, stent komplikasyonu, karotid arter stenozu, stent trombozu

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