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Borhani-Haghighi A, Hooshmandi E, Zahediasl F, Molavi Vardanjani H, Rezaei M, Rahimi-Jaberi A, Ashjazadeh N, Petramfar P, Ostovan VR, Fadakar N, Poursadeghfard M, Izadi S, Nazeri M, Zafarmand SS, Bayat M, Salehi MS, Owjfard M, Sedighi B, Iranmanesh F, Shafiei K, Vakilian A, Moghadam Ahmadi A, Nemati R, Rezaeian Jahromi F, Jalalijahromi M, Kashani K, Razmeh S, Bahrehbar M, Basir M, Qureshi AI. Early and mid-term outcomes of carotid angioplasty and stent placement in 579 patients. J Neuroimaging 2022; 32:1161-1169. [PMID: 35969379 DOI: 10.1111/jon.13036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/11/2022] [Accepted: 07/28/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE Carotid angioplasty and stenting (CAS) could be considered for preventing stroke in patients with carotid artery stenosis. This study aimed to determine the incidence and the risk factors of the early and mid-term complications associated with CAS. METHODS This is a retrospective cohort study conducted at Shiraz University of Medical Sciences from March 2011 to March 2019. Patients at high risk and standard risk for carotid endarterectomy were included. The primary composite outcome was defined as stroke, myocardial infarction (MI), and death in the first 30 days after CAS. All-cause mortality, vascular mortality, and stroke were investigated during mid-term follow-up. RESULTS A total of 579 patients (618 CAS) were recruited (mean age: 71.52 years). Overall, 394 (68.40%), 211 (36.63%), 179 (31.07%), and 96 (16.72%) patients had hypertension, dyslipidemia, diabetes mellitus, or were cigarette smokers, respectively. Primary composite outcomes were observed in 2.59% of patients (1.55% stroke, 0.69% MI, and 1.72% death). Atrial fibrillation was a predictor of primary composite outcome in multivariate logistic regression (p = .048). The presence of total occlusion in the contralateral carotid artery was significantly associated with the risk of stroke in univariate logistic regression (p = .041). The patients were followed for a period ranging from 1 to 83 months. The overall survival rate for all-cause mortality was 93.48% at 1 year, 77.24% at 5 years, and 52.92% at 8 years. All-cause mortality was significantly higher among patients with symptomatic carotid stenosis (p = .014). CONCLUSION CAS provides acceptable short-term and mid-term outcomes in a unique population of high- and standard-surgical-risk, symptomatic and asymptomatic, octogenarian, and nonoctogenarian patients.
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Affiliation(s)
| | - Etrat Hooshmandi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farzaneh Zahediasl
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Molavi Vardanjani
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahdiyeh Rezaei
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Rahimi-Jaberi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nahid Ashjazadeh
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Petramfar
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahid Reza Ostovan
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nima Fadakar
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Poursadeghfard
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sadegh Izadi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoumeh Nazeri
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mahnaz Bayat
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Saied Salehi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Owjfard
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Behnaz Sedighi
- Neurology Research Center, Kerman University of Medical Science, Kerman, Iran
| | - Farhad Iranmanesh
- Neurology Research Center, Kerman University of Medical Science, Kerman, Iran
| | - Kaveh Shafiei
- Neurology Research Center, Kerman University of Medical Science, Kerman, Iran
| | - Alireza Vakilian
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Amir Moghadam Ahmadi
- Neuro-immunology Research Scholar, Thomas Jefferson University, Philadelphia, PA, USA
| | - Reza Nemati
- Department of Neurology, Bushehr Medical University Hospital, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | | | - Kaveh Kashani
- Department of Neurology, Fasa University of Medical Sciences, Fasa, Iran
| | - Saeed Razmeh
- Department of Neurology, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Mansour Bahrehbar
- Department of Neurology, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Marzieh Basir
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Adnan I Qureshi
- Zeenat Qureshi Stroke Institute and University of Missouri, Columbia, Missouri, USA
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