Background And Purpose: Restenosis after carotid angioplasty (with or without stent) is associated with increased rate of stroke and death. Our aim was to determine risk and predictive factors related to carotid restenosis post carotid angioplasty and its association to recurrent cerebrovascular events.
Methods: All consecutive patients with carotid stenosis treated with angioplasty (n=1060) in a single University Hospital were included (from 2002 to 2013). Follow-up was done prospectively evaluating restenosis, ipsilateral stroke, or death. Restenosis was defined as a narrowing of ≥70% of a previously treated vessel evaluated by ultrasonography.
Results: Of the 1060 patients treated, 9.2% (97) of patients experienced restenosis during follow up (median 12 [9-32] months). Occurrence of restenosis was associated with ipsilateral stroke during follow-up (P=0.049). After Cox regression analysis, hypertension (hazard ratio, 6.2 [1.9-19.9]; P=0.002), impaired vasoreactivity (hazard ratio, 1.7 [1.09-2.8]; P=0.019), and angioplasty without stent (hazard ratio, 2.9 [1.2-6.8]; P=0.012) were independent risk predictors of >70% restenosis.
Conclusions: Carotid restenosis after carotid angioplasty is associated with ipsilateral stroke occurrence. In our sample, hypertension, angioplasty without stent, and impaired vasoreactivity identify patients at high risk of restenosis and could help to select patients for follow-up ultrasonography imaging.
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http://dx.doi.org/10.1161/STROKEAHA.116.012650 | DOI Listing |
J Clin Med
December 2024
"Joint-Stock Company" Central Clinical Hospital, Almaty 050060, Kazakhstan.
Intracranial atherosclerosis (ICAS) is a major cause of ischemic stroke, disproportionately affecting populations with significant vascular risk factors. Although ICAS imposes a considerable health burden, research on this condition in Central Asia remains scarce, especially among the Kazakh population. This study analyzes demographic characteristics, treatment outcomes, and procedural challenges associated with ICAS in 216 patients treated at a single institution.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
January 2025
Department of Internal Medicine, Vascular Medicine Outcomes Program (VAMOS), Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Background: Evaluating health status changes following transfemoral carotid artery stenting (TF-CAS) is essential for assessing procedural success, but meaningful clinical changes are unknown. We aimed to determine minimal clinically important differences (MCIDs) and quantify health status improvement or worsening rates after TF-CAS using the Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy (SAPPHIRE) registry data.
Methods: The SAPPHIRE registry included patients undergoing TF-CAS from 2010 to 2014 for both symptomatic and asymptomatic carotid stenosis.
Cureus
December 2024
Department of Neurosurgery, Hirosaki University Graduate School of Medicine, Hirosaki, JPN.
Tandem occlusion due to acute cervical carotid artery dissection should be promptly treated with thrombectomy for reperfusion. If the cervical lesion has reached severe stenosis or complete occlusion, balloon angioplasty and, in certain cases, carotid artery stenting should be performed before thrombectomy for the intracranial lesion. Angioplasty or stent placement is performed in the true lumen, but securing the placement is challenging when the true lumen cannot be determined.
View Article and Find Full Text PDFEur J Radiol
December 2024
Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. Electronic address:
Background And Purpose: The quantitative intra-arterial flow dynamics following percutaneous transluminal angioplasty and stenting (PTAS) for severe intracranial artery stenosis have never been investigated. We aimed to evaluate peritherapeutic intracranial artery flow dynamics following PTAS with quantitative magnetic resonance angiography (qMRA) to predict long-term stent patency.
Design: This is a prospective, single-center study.
J Clin Neurosci
January 2025
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China; China International Neuroscience Institute (China-INI), Beijing 100053, China; Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China. Electronic address:
Unlabelled: Carotid Blowout Syndrome (CBS) is a rare and life-threatening condition that necessitates prompt intervention to prevent fatal hemorrhage. This study compares the outcomes of two primary endovascular approaches: reconstructive interventions, which aim to preserve carotid artery function using stents or balloon angioplasty, and deconstructive interventions, which involve vessel occlusion to halt bleeding. A systematic review and meta-analysis were performed by searching multiple databases for relevant studies published from January 2000 to August 2023.
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