11 Short-term predictors of risk of stenting for symptomatic carotid stenosis—data from the International Carotid Stenting Study (ICSS). Issue 3 (15th February 2011)

• Record Type: Journal Article
• Authors: Doig, D; Featherstone, R L; Brown, M M
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 82:Issue 3(2011)
• Page Start: e1
• Page End: e1
• Publication Date: 2011-02-15
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp.2010.235572.11
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Background: ICSS showed a significantly higher rate of stroke, myocardial infarction (MI) or death after carotid artery stenting (CAS) compared with endarterectomy. We therefore examined risk factors for CAS. Methods: Per-protocol analysis was performed investigating baseline characteristics influencing the risk of stroke, MI or death 30 days after CAS. Logarithmic binomial regression was used to compare this risk in each subgroup. Results: CAS was initiated in 828/853 patients allocated stenting. 61 patients suffered stroke, death or MI within 30 days. In univariate analysis, the rate of stroke, MI or death was higher in those patients undergoing a left compared to right-sided procedure (9.4% vs 5.1%, p=0.019), in those who never smoked compared to current smokers (10.2% vs 2.5%, p=0.004), in those with atrial fibrillation (15.4% vs 6.7%, p=0.017), in those with Rankin Score of 4 compared to 0 (17.6% vs 5.9%, p=0.051), in those with stroke compared to amaurosis fugax as the index event (8.4% vs 2.1%, p=0.019), and in those randomised in centres who recruited <50 patients (10.0% vs 5.9%, p=0.035). Each additional year of age conferred additional risk. These results were attenuated in multivariate analysis. Patients with multiple risk factors experienced a higher rate of events (3.1%, 6.3%, 15.2% for 0–1, 2–3, or 4–5 risk factors respectively). Conclusion: Knowledge of risk factors might be useful in selecting and advising patients on the risk of carotid stenting.