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Early carotid artery stenting for symptomatic carotid artery stenosis

  • Clinical Article - Vascular
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Abstract

Background

The aim of present study was to assess safety and efficacy of early carotid artery stent (CAS) in patients with symptomatic carotid artery stenosis compared with delayed CAS.

Methods

This retrospective study was approved by the institutional review board, and the requirement to obtain written informed consent was waived. Outcomes of 206 patients with symptomatic carotid stenosis who were treated by CAS were analyzed. According to CAS timing from last symptom, patients were divided into early (within 2 weeks, 74 [35.0 %]) and delayed (after 2 weeks, 112 [64.1 %]) group by CAS timing from the last symptom. Procedural complication and early (≤30 days of CAS) event (ipsilateral stroke or any death) for safety, and late (31 days to 1 year of CAS) event for efficacy of CAS preventing further stroke were evaluated. The two groups were compared using Cox proportional hazard analysis.

Results

No difference was found in procedural complication between the groups (early 2 [2.7 %] vs. delayed group 7 [5.3 %], hazard ratio [HR] 0.61, 95 % confidence interval [CI] 0.123–2.979, p = 0.537). In the early group, however, early event developed more frequently than in the late group (9 [12.2 %] vs. 1 [0.8 %], HR 16.05, 95 % CI 1.991–129.438, p = 0.009). The late event rate showed no difference between the two groups (4 [5.4 %] vs. 4 [3.0 %], HR 2.09, 95 % CI 0.484–8.989, p = 0.324).

Conclusions

Early CAS is not safe during periprocedural period, compared with late CAS. In CAS for symptomatic carotid stenosis, delayed CAS should be considered.

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Acknowledgments

This study was supported by grant no 02-2013-007 from the SNUBH Research Fund.

Conflicts of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speaker’s bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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Authors and Affiliations

  1. Department of Neurosurgery, Neurovascular Center of New Korea Hospital, Gimpo, Gyeonggi Province, South Korea

    Kyung Sun Song

  2. Department of Neurosurgery, Seoul National University College of Medicine, Bundang Hospital, 300 Gumi-dong, Bungdang-gu, Seongnam, Gyeonggi, 463-707, South Korea

    O-Ki Kwon, Gyojun Hwang, Jae Seung Bang & Chang Wan Oh

  3. Department of Neurology, Seoul National University College of Medicine, Bundang Hospital, Seongnam, South Korea

    Hee-Joon Bae, Moon-Ku Han & Beom Joon Kim

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  1. Kyung Sun Song
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Correspondence to O-Ki Kwon.

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This study was not presented and has not been accepted for presentation at any meeting

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Song, K.S., Kwon, OK., Hwang, G. et al. Early carotid artery stenting for symptomatic carotid artery stenosis. Acta Neurochir 157, 1873–1878 (2015). https://doi.org/10.1007/s00701-015-2548-8

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