Residual stenosis after carotid artery stenting: Effect on periprocedural and long-term outcomes

• Published in: PloS one Vol. 14; no. 9; p. e0216592
• Main Authors: Kang, Jihoon, Hong, Jeong-Ho, Kim, Beom Joon, Bae, Hee-Joon, Kwon, O-Ki, Oh, Chang Wan, Jung, Cheolkyu, Lee, Ji Sung, Han, Moon-Ku
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 09.09.2019; Public Library of Science (PLoS)
• Subjects: Aged; Aged, 80 and over; Analysis; Angiography; Arterial stenosis; Asymptomatic Diseases; Biology and Life Sciences; Cardiology; Care and treatment; Carotid arteries; Carotid Arteries - diagnostic imaging; Carotid Arteries - pathology; Carotid Arteries - surgery; Carotid artery; Carotid artery diseases; Carotid Stenosis - diagnostic imaging; Carotid Stenosis - mortality; Carotid Stenosis - pathology; Carotid Stenosis - surgery; Clopidogrel; Confidence intervals; Coronary Angiography; Diagnostic imaging; Dissection; Female; Health hazards; Heart attacks; Hemodynamics; Hospitals; Humans; Hypertension; Male; Medical imaging; Medicine and Health Sciences; Middle Aged; Neurology; Neurosurgery; Patients; Proportional Hazards Models; Registries; Regression analysis; Regression models; Republic of Korea; Restenosis; Retrospective Studies; Severity of Illness Index; Statins; Statistical analysis; Stenosis; Stents; Stroke; Survival analysis; Treatment Outcome; Veins & arteries; Republic of Korea; South Korea
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0216592

This study investigated the effect of residual stenosis after carotid artery stenting (CAS) on periprocedural and long-term outcomes. Patients treated with CAS for symptomatic or asymptomatic carotid arterial stenosis were consecutively enrolled. Residual stenosis was estimated from post-procedure angiography findings. The effects of residual stenosis on 30-day periprocedural outcome and times to restenosis and clinical outcome were analyzed using logistic regression models and Wei-Lin-Weissfeld models, respectively. A total of 412 patients (age, 64.7 ± 17.0 years; male, 82.0%) were enrolled. The median baseline stenosis was 80% (interquartile range [IQR], 70-90%), which improved to 10% (0-30%) for residual stenosis. Residual stenosis was significantly associated with periprocedural outcome (adjusted odds ratio, 0.983; 95% confidence interval [CI], 0.965-0.999, P = 0.01) after adjustment for baseline stenosis, age, hypertension, symptomaticity, and statin use. Over the 5-year observation period, residual stenosis did not increase the global hazard for restenosis and clinical outcome (adjusted hazard ratio, 1.011; 95% CI, 0.997-1.025. In the event-specific model, residual stenosis increased the hazard for restenosis (adjusted hazard ratio, 1.041; 1.012-1.072) but not for clinical outcome (adjusted hazard ratio, 1.011; 0.997-1.025). Residual stenosis after carotid artery stenting may be useful to predict periprocedural outcome and restenosis.