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Effect of high-dose strong statin for preventing periprocedural ischemic complications of carotid artery stenting

  • Norihiko ShinozakiEmail author
  • Tsutomu Murakami
  • Yohei Ohno
  • Masataka Nakano
  • Toshiharu Fujii
  • Gaku Nakazawa
  • Fuminobu Yoshimachi
  • Yuji Ikari
Original Article

Abstract

Statin therapy has been shown to induce carotid atherosclerotic plaque regression and reduce the periprocedural ischemic complications of carotid artery stenting (CAS). This study assessed the safety and usefulness of pretreatment using a high-dose strong statin (HDSS) to reduce the periprocedural ischemic complications of CAS. We analyzed 117 carotid lesions treated by CAS that were evaluated with magnetic resonance imaging (MRI) within 48 h after the procedure. For 67 lesions, an HDSS (rosuvastatin 20 mg or atorvastatin 40 mg daily) were prescribed from at least 14 days before CAS to at least 14 days after procedure (HDSS group). Clinical and angiographic data, as well as in-hospital outcomes, of the HDSS group were retrospectively compared with 50 lesions with conventional treatment without an HDSS (non-HDSS group). There were no significant differences in the baseline clinical and procedural characteristics between the two groups. There was no side effect related to the HDSS. Stroke rates were similar between the two groups (3.0% in HDSS group vs 8.0% in non-HDSS group, p = 0.22). All were minor strokes. Compared to the non-HDSS group, the HDSS group had a lower frequency of new lesions on diffusion-weighted imaging (DWI) with MRI (25.4% vs 44.0%, p = 0.0345). New ipsilateral DWI-positive rate in the HDSS group was significantly lower than in the non-HDSS group (16.4% vs 34.0%, p = 0.0275). Nonipsilateral (contralateral or posterior circulation) DWI-positive rates were similar between the two groups (13.4% vs 20.0%, p = 0.34). Pretreatment with an HDSS might reduce the periprocedural ischemic complications of CAS.

Keywords

Carotid artery stenosis Carotid artery stenting Strong statin Ischemic complication Magnetic resonance imaging Diffusion-weighted imaging 

Abbreviations

CAS

Carotid artery stenting

CEA

Carotid endarterectomy

HDSS

High-dose strong statin

MRI

Magnetic resonance imaging

DWI

Diffusion-weighted imaging

Notes

Compliance with ethical standards

Conflict of interest

None.

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Copyright information

© Springer Japan KK, part of Springer Nature 2020

Authors and Affiliations

  • Norihiko Shinozaki
    • 1
    Email author
  • Tsutomu Murakami
    • 1
  • Yohei Ohno
    • 1
  • Masataka Nakano
    • 1
  • Toshiharu Fujii
    • 1
  • Gaku Nakazawa
    • 1
  • Fuminobu Yoshimachi
    • 1
  • Yuji Ikari
    • 1
  1. 1.Department of CardiologyTokai University School of MedicineIseharaJapan

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