Background: Carotid artery stenting (CAS) has become a cornerstone of carotid revascularization for stroke prevention. Despite the advantages of CAS, large-scale randomized trials involving prior (single-layer) first generation stents (FGS) demonstrated a higher risk of periprocedural cerebrovascular events compared to surgery. Dual-layer mesh-covered stents (DLSs) showed promising results in terms of 30-day embolic events in initial studies; larger-scale evidence is accumulating. This study aims to evaluate 30-day clinical efficacy of DLS against a closed-cell stent, based on large-volume data.
Methods: The study center is part of the Italian National Outcomes Evaluation Program (PNE). CAS procedures performed between November 2017 and September 2023 were eneterd into a prospectively collected database. Our The primary endpoint was survival free of death, stroke, and myocardial infarction (MI) at 30 days. In addition, technical success and periprocedural major adverse clinical event rate (with a focus on stroke) were also evaluated.
Results: Over a total of 1101 CAS procedures (745 males; mean age 79±7.8 years), 48.6% were symptomatic. Majority (80.2%) were treated with DLSs. Technical success was achieved in 98.9%. The FGSs group showed a significantly higher peri-procedural stroke rate when compared with CGuard and Roadsaver DLS: 4.59% vs. 1.18% vs. 2.63% (P=0.008); minor stroke rates were 4.13% vs. 0.83% and 0% P=0.01). The cumulative stroke, MI and death - free survival at 30 days was 97.46%. A statistically significant higher cumulative 30-day death/stroke/MI rate occurred in FGSs-treated patients compared to the CGuard and Roadsaver DLS-treated (6.42% vs. 1.42% and 2.63%, P=0.001).
Conclusions: The use of DLS in patients undergoing CAS in our large-volume center showed a high technical success rate and minimal cerebral embolic complications by 30 days. High volumes and an experienced interventional team may contribute to these favorable outcomes.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.23736/S0021-9509.24.13033-9 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Maxillomandibular Advancement Safety and Effectiveness in Obstructive Sleep Apnea: Systematic Review and Meta-Analysis.
Otolaryngol Head Neck Surg
January 2025
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Objective: To provide an updated evaluation of clinical effectiveness and sequelae of maxillomandibular advancement surgery in obstructive sleep apnea.
Data Sources: PubMed, Scopus, CINAHL.
Review Methods: Included studies described patients with obstructive sleep apnea that completed maxillomandibular advancement with any reported sequelae.
Innovative Integration of Robotic-Assisted Laparoscopic Telesurgery and Quantum Cryptography Communication in Urology: Clinical Application and Initial Experience.
Int J Med Robot
February 2025
Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Background: The emergence of telesurgery has received global interest, with secure network transmission identified as a crucial determinant of its success. This study aimed to evaluate the safety and viability of employing quantum cryptography communication in remote partial nephrectomy.
Methods: The surgeon operated on the patient from a distance of over 260 km using remote control of a surgical robot.
Therapies against hematological malignancies using chimeric antigen receptors (CAR)-T cells have shown great potential; however, therapeutic success in solid tumors has been constrained due to limited tumor trafficking and infiltration, as well as the scarcity of cancer-specific solid tumor antigens. Therefore, the enrichment of tumor-antigen specific CAR-T cells in the desired region is critical for improving therapy efficacy and reducing systemic on-target/off-tumor side effects. Here, we functionalized human CAR-T cells with superparamagnetic iron oxide nanoparticles (SPIONs), making them magnetically controllable for site-directed targeting.
View Article and Find Full Text PDFAI predictive models and advancements in microdissection testicular sperm extraction for non-obstructive azoospermia: a systematic scoping review.
Hum Reprod Open
November 2024
Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Study Question: How accurately can artificial intelligence (AI) models predict sperm retrieval in non-obstructive azoospermia (NOA) patients undergoing micro-testicular sperm extraction (m-TESE) surgery?
Summary Answer: AI predictive models hold significant promise in predicting successful sperm retrieval in NOA patients undergoing m-TESE, although limitations regarding variability of study designs, small sample sizes, and a lack of validation studies restrict the overall generalizability of studies in this area.
What Is Known Already: Previous studies have explored various predictors of successful sperm retrieval in m-TESE, including clinical and hormonal factors. However, no consistent predictive model has yet been established.
Practice patterns among ophthalmic surgeons in treating concomitant oculoplastic conditions in preoperative period: A questionnaire-based study.
World J Clin Cases
January 2025
Department of Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar 751019, Odisha, India.
Background: Addressing oculoplastic conditions in the preoperative period ensures both the safety and functional success of any ophthalmic procedure. Some oculoplastic conditions, like nasolacrimal duct obstruction, have been extensively studied, whereas others, like eyelid malposition and thyroid eye disease, have received minimal or no research.
Aim: To investigate the current practice patterns among ophthalmologists while treating concomitant oculoplastic conditions before any subspecialty ophthalmic intervention.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!