Carotid artery stenting: Influence of experience and cerebrovascular risk factors on outcome
Abstract Aim To evaluate technical success, complications and the influence of the learning curve on outcome in carotid artery stenting (CAS) performed in patients not suitable for surgery. Patients and methods One hundred and nine procedures of protected carotid stenting in 103 high risk patients w...
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| Veröffentlicht in: | Diagnostic and interventional imaging 2014-04, Vol.95 (4), p.421-426 |
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| creator | Carrafiello, G De Lodovici, M.L Piffaretti, G Rivolta, N Ierardi, A.M Petrillo, M Facchinetti, A Carimati, F Verrengia, E.P Mauri, M Tsetis, D |
| description | Abstract Aim To evaluate technical success, complications and the influence of the learning curve on outcome in carotid artery stenting (CAS) performed in patients not suitable for surgery. Patients and methods One hundred and nine procedures of protected carotid stenting in 103 high risk patients were performed. All patients presented at least one factor that potentially increased the surgical risk of carotid endoarterectomy (CEA), according to SAPPHIRE criteria. Neurologic complications were quantified by the National Institutes of Health Stroke Scale (NIHSS) and were evaluated by median Rankin Scale (mRS). To evaluate the influence of experience of the operator to perform CAS, we retrospectively analyzed periprocedural and neurological complications of the first 50 procedures compared with that of the following 59 interventions. Results Technical success rate was 98%. Neurological periprocedural complications were revealed in 4.5% of patients. In-hospital and 30-days neurological complications rate was 7.6 and 2.6% respectively. Periprocedural neurological complications rate was lower in the last procedures performed, according to a higher confidence of the operators. Conclusions CAS may be performed as an alternative of CEA for the treatment of severe carotid obstructive disease in patients not suitable for surgery. The learning curve positively influence complications rate. |
| doi_str_mv | 10.1016/j.diii.2013.12.003 |
| format | Article |
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Patients and methods One hundred and nine procedures of protected carotid stenting in 103 high risk patients were performed. All patients presented at least one factor that potentially increased the surgical risk of carotid endoarterectomy (CEA), according to SAPPHIRE criteria. Neurologic complications were quantified by the National Institutes of Health Stroke Scale (NIHSS) and were evaluated by median Rankin Scale (mRS). To evaluate the influence of experience of the operator to perform CAS, we retrospectively analyzed periprocedural and neurological complications of the first 50 procedures compared with that of the following 59 interventions. Results Technical success rate was 98%. Neurological periprocedural complications were revealed in 4.5% of patients. In-hospital and 30-days neurological complications rate was 7.6 and 2.6% respectively. Periprocedural neurological complications rate was lower in the last procedures performed, according to a higher confidence of the operators. Conclusions CAS may be performed as an alternative of CEA for the treatment of severe carotid obstructive disease in patients not suitable for surgery. The learning curve positively influence complications rate.</description><identifier>ISSN: 2211-5684</identifier><identifier>EISSN: 2211-5684</identifier><identifier>DOI: 10.1016/j.diii.2013.12.003</identifier><identifier>PMID: 24512895</identifier><language>eng</language><publisher>France: Elsevier Masson SAS</publisher><subject>Aged ; Aged, 80 and over ; Carotid Arteries - surgery ; Carotid Stenosis - complications ; Carotid Stenosis - surgery ; Carotid stenting ; Cerebrovascular Disorders - etiology ; Cerebrovascular Disorders - prevention & control ; Cerebrovascular risk factors ; Clinical Competence ; Experience ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Outcomes ; Radiology ; Retrospective Studies ; Risk Factors ; Stents ; Treatment Outcome</subject><ispartof>Diagnostic and interventional imaging, 2014-04, Vol.95 (4), p.421-426</ispartof><rights>Éditions françaises de radiologie</rights><rights>2013 Éditions françaises de radiologie</rights><rights>Copyright © 2013 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-bf8a16a8145175ab7e142a0ba1a4bdb56af70284916888879b000553a800f5fb3</citedby><cites>FETCH-LOGICAL-c455t-bf8a16a8145175ab7e142a0ba1a4bdb56af70284916888879b000553a800f5fb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24512895$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Carrafiello, G</creatorcontrib><creatorcontrib>De Lodovici, M.L</creatorcontrib><creatorcontrib>Piffaretti, G</creatorcontrib><creatorcontrib>Rivolta, N</creatorcontrib><creatorcontrib>Ierardi, A.M</creatorcontrib><creatorcontrib>Petrillo, M</creatorcontrib><creatorcontrib>Facchinetti, A</creatorcontrib><creatorcontrib>Carimati, F</creatorcontrib><creatorcontrib>Verrengia, E.P</creatorcontrib><creatorcontrib>Mauri, M</creatorcontrib><creatorcontrib>Tsetis, D</creatorcontrib><title>Carotid artery stenting: Influence of experience and cerebrovascular risk factors on outcome</title><title>Diagnostic and interventional imaging</title><addtitle>Diagn Interv Imaging</addtitle><description>Abstract Aim To evaluate technical success, complications and the influence of the learning curve on outcome in carotid artery stenting (CAS) performed in patients not suitable for surgery. Patients and methods One hundred and nine procedures of protected carotid stenting in 103 high risk patients were performed. All patients presented at least one factor that potentially increased the surgical risk of carotid endoarterectomy (CEA), according to SAPPHIRE criteria. Neurologic complications were quantified by the National Institutes of Health Stroke Scale (NIHSS) and were evaluated by median Rankin Scale (mRS). To evaluate the influence of experience of the operator to perform CAS, we retrospectively analyzed periprocedural and neurological complications of the first 50 procedures compared with that of the following 59 interventions. Results Technical success rate was 98%. Neurological periprocedural complications were revealed in 4.5% of patients. In-hospital and 30-days neurological complications rate was 7.6 and 2.6% respectively. Periprocedural neurological complications rate was lower in the last procedures performed, according to a higher confidence of the operators. Conclusions CAS may be performed as an alternative of CEA for the treatment of severe carotid obstructive disease in patients not suitable for surgery. The learning curve positively influence complications rate.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Carotid Arteries - surgery</subject><subject>Carotid Stenosis - complications</subject><subject>Carotid Stenosis - surgery</subject><subject>Carotid stenting</subject><subject>Cerebrovascular Disorders - etiology</subject><subject>Cerebrovascular Disorders - prevention & control</subject><subject>Cerebrovascular risk factors</subject><subject>Clinical Competence</subject><subject>Experience</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Outcomes</subject><subject>Radiology</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Stents</subject><subject>Treatment Outcome</subject><issn>2211-5684</issn><issn>2211-5684</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2LFDEQhoMo7rLuH_AgOXqZNpVOejIiggx-LCx4UMGDEJJ0RTLbk4xJenH-vemdVcSDdUkC71OkniLkKbAOGAwvdt0YQug4g74D3jHWPyDnnAOs5KDEw7_uZ-SylB1rNTRQiMfkjAsJXG3kOfm2NTnVMFKTK-YjLRVjDfH7S3oV_TRjdEiTp_jzgDncvUwcqcOMNqdbU9w8mUxzKDfUG1dTLjRFmubq0h6fkEfeTAUv788L8uXd28_bD6vrj--vtm-uV05IWVfWKwODUdB-tZbGrhEEN8waMMKOVg7GrxlXYgODarXe2DaLlL1RjHnpbX9Bnp_6HnL6MWOpeh-Kw2kyEdNcNEhQXPQD27QoP0VdTqVk9PqQw97kowamF7F6pxexehGrgesmtkHP7vvPdo_jH-S3xhZ4dQpgm_I2YNbF3dkaQ0ZX9ZjC__u__gd3U4jBmekGj1h2ac6x-dOgSwP0p2W1y2ahb7RiX_tfuFmeMw</recordid><startdate>20140401</startdate><enddate>20140401</enddate><creator>Carrafiello, G</creator><creator>De Lodovici, M.L</creator><creator>Piffaretti, G</creator><creator>Rivolta, N</creator><creator>Ierardi, A.M</creator><creator>Petrillo, M</creator><creator>Facchinetti, A</creator><creator>Carimati, F</creator><creator>Verrengia, E.P</creator><creator>Mauri, M</creator><creator>Tsetis, D</creator><general>Elsevier Masson SAS</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140401</creationdate><title>Carotid artery stenting: Influence of experience and cerebrovascular risk factors on outcome</title><author>Carrafiello, G ; De Lodovici, M.L ; Piffaretti, G ; Rivolta, N ; Ierardi, A.M ; Petrillo, M ; Facchinetti, A ; Carimati, F ; Verrengia, E.P ; Mauri, M ; Tsetis, D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-bf8a16a8145175ab7e142a0ba1a4bdb56af70284916888879b000553a800f5fb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Carotid Arteries - surgery</topic><topic>Carotid Stenosis - complications</topic><topic>Carotid Stenosis - surgery</topic><topic>Carotid stenting</topic><topic>Cerebrovascular Disorders - etiology</topic><topic>Cerebrovascular Disorders - prevention & control</topic><topic>Cerebrovascular risk factors</topic><topic>Clinical Competence</topic><topic>Experience</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Outcomes</topic><topic>Radiology</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Stents</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Carrafiello, G</creatorcontrib><creatorcontrib>De Lodovici, M.L</creatorcontrib><creatorcontrib>Piffaretti, G</creatorcontrib><creatorcontrib>Rivolta, N</creatorcontrib><creatorcontrib>Ierardi, A.M</creatorcontrib><creatorcontrib>Petrillo, M</creatorcontrib><creatorcontrib>Facchinetti, A</creatorcontrib><creatorcontrib>Carimati, F</creatorcontrib><creatorcontrib>Verrengia, E.P</creatorcontrib><creatorcontrib>Mauri, M</creatorcontrib><creatorcontrib>Tsetis, D</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Diagnostic and interventional imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Carrafiello, G</au><au>De Lodovici, M.L</au><au>Piffaretti, G</au><au>Rivolta, N</au><au>Ierardi, A.M</au><au>Petrillo, M</au><au>Facchinetti, A</au><au>Carimati, F</au><au>Verrengia, E.P</au><au>Mauri, M</au><au>Tsetis, D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Carotid artery stenting: Influence of experience and cerebrovascular risk factors on outcome</atitle><jtitle>Diagnostic and interventional imaging</jtitle><addtitle>Diagn Interv Imaging</addtitle><date>2014-04-01</date><risdate>2014</risdate><volume>95</volume><issue>4</issue><spage>421</spage><epage>426</epage><pages>421-426</pages><issn>2211-5684</issn><eissn>2211-5684</eissn><abstract>Abstract Aim To evaluate technical success, complications and the influence of the learning curve on outcome in carotid artery stenting (CAS) performed in patients not suitable for surgery. Patients and methods One hundred and nine procedures of protected carotid stenting in 103 high risk patients were performed. All patients presented at least one factor that potentially increased the surgical risk of carotid endoarterectomy (CEA), according to SAPPHIRE criteria. Neurologic complications were quantified by the National Institutes of Health Stroke Scale (NIHSS) and were evaluated by median Rankin Scale (mRS). To evaluate the influence of experience of the operator to perform CAS, we retrospectively analyzed periprocedural and neurological complications of the first 50 procedures compared with that of the following 59 interventions. Results Technical success rate was 98%. Neurological periprocedural complications were revealed in 4.5% of patients. In-hospital and 30-days neurological complications rate was 7.6 and 2.6% respectively. Periprocedural neurological complications rate was lower in the last procedures performed, according to a higher confidence of the operators. Conclusions CAS may be performed as an alternative of CEA for the treatment of severe carotid obstructive disease in patients not suitable for surgery. The learning curve positively influence complications rate.</abstract><cop>France</cop><pub>Elsevier Masson SAS</pub><pmid>24512895</pmid><doi>10.1016/j.diii.2013.12.003</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Carotid Arteries - surgery Carotid Stenosis - complications Carotid Stenosis - surgery Carotid stenting Cerebrovascular Disorders - etiology Cerebrovascular Disorders - prevention & control Cerebrovascular risk factors Clinical Competence Experience Female Follow-Up Studies Humans Male Middle Aged Outcomes Radiology Retrospective Studies Risk Factors Stents Treatment Outcome |
| title | Carotid artery stenting: Influence of experience and cerebrovascular risk factors on outcome |
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