Carotid Restenosis Rate After Stenting for Primary Lesions Versus Restenosis After Endarterectomy With Creation of Risk Index
Нема приказа
Аутори
Tanasković, SlobodanSagić, Dragan Ž.
Radak, Đorđe J.
Antonić, Želimir
Kovačević, Vladimir
Vuković, Mira
Aleksić, Nikola
Radak, Sandra
Nenezić, Dragoslav
Cvetković, Slobodan M.
Isenović, Esma R.
Vučurević, Goran
Lozuk, Branko
Babić, Aleksandar
Babić, Srđan
Matić, Predrag
Gajin, Predrag
Unić-Stojanović, Dragana
Ilijevski, Nenad
Чланак у часопису (Објављена верзија)
Метаподаци
Приказ свих података о документуАпстракт
Purpose: Carotid artery stenting (CAS) is an option for carotid restenosis (CR) treatment with favorable outcomes. However, CAS has also emerged as an alternative to carotid endarterectomy (CEA) for the management of patients with primary carotid stenosis. This study aimed to report CR rates after CAS was performed in patients with primary lesions versus restenosis after CEA, to identify predictors of CR, and to report both neurological and overall outcomes.Materials and methods:From January 2000 to September 2018, a total of 782 patients were divided into 2 groups: The CAS (prim) group consisted of 440 patients in whom CAS was performed for primary lesions, and the CAS (res) group consisted of 342 patients with CAS due to restenosis after CEA. Indications for CAS were symptomatic stenosis/restenosis >70% and asymptomatic stenosis/restenosis >85%. A color duplex scan (CDS) of carotid arteries was performed 6 months after CAS, after 1 year, and annually afterward. Follow-up ranged from ...12 to 88 months, with a mean follow-up of 34.6±18.0 months.Results:There were no differences in terms of CR rate between the patients in the CAS (prim) and CAS (res) groups (8.7% vs 7.2%, ?2=0.691, p=0.406). The overall CR rate was 7.9%, whereas significant CR (>70%) rate needing re-intervention was 5.6%, but there was no difference between patients in the CAS (prim) and CAS (res) groups (6.4% vs 4.7%, p=0.351). Six independent predictors for CR were smoking, associated previous myocardial infarction and angina pectoris, plaque morphology, spasm after CAS, the use of FilterWire or Spider Fx cerebral protection devices, and time after stenting. A carotid restenosis risk index (CRRI) was created based on these predictors and ranged from ?7 (minimal risk) to +10 (maximum risk); patients with a score >?4 were at increased risk for CR. There were no differences in terms of neurological and overall morbidity and mortality between the 2 groups.Conclusions:There was no difference in CR rate after CAS between the patients with primary stenosis and restenosis after CEA. A CRRI score >?4 is a criterion for identifying high-risk patients for post-CAS CR that should be tested in future randomized trials.
Кључне речи:
carotid artery / carotid restenosis / carotid stenting / embolic protection deviceИзвор:
Journal of Endovascular Therapy, 2022, 15266028221091895-Финансирање / пројекти:
- Каротидна болест у Србији - патолошка динамика, превенција, дијагностика и иновативни терапијски поступци (RS-MESTD-Integrated and Interdisciplinary Research (IIR or III)-41002)
DOI: 10.1177/15266028221091895
ISSN: 1526-6028
PubMed: 35466778
WoS: 00078804370000
Scopus: 2-s2.0-85129536467
Колекције
Институција/група
VinčaTY - JOUR AU - Tanasković, Slobodan AU - Sagić, Dragan Ž. AU - Radak, Đorđe J. AU - Antonić, Želimir AU - Kovačević, Vladimir AU - Vuković, Mira AU - Aleksić, Nikola AU - Radak, Sandra AU - Nenezić, Dragoslav AU - Cvetković, Slobodan M. AU - Isenović, Esma R. AU - Vučurević, Goran AU - Lozuk, Branko AU - Babić, Aleksandar AU - Babić, Srđan AU - Matić, Predrag AU - Gajin, Predrag AU - Unić-Stojanović, Dragana AU - Ilijevski, Nenad PY - 2022 UR - https://vinar.vin.bg.ac.rs/handle/123456789/10259 AB - Purpose: Carotid artery stenting (CAS) is an option for carotid restenosis (CR) treatment with favorable outcomes. However, CAS has also emerged as an alternative to carotid endarterectomy (CEA) for the management of patients with primary carotid stenosis. This study aimed to report CR rates after CAS was performed in patients with primary lesions versus restenosis after CEA, to identify predictors of CR, and to report both neurological and overall outcomes.Materials and methods:From January 2000 to September 2018, a total of 782 patients were divided into 2 groups: The CAS (prim) group consisted of 440 patients in whom CAS was performed for primary lesions, and the CAS (res) group consisted of 342 patients with CAS due to restenosis after CEA. Indications for CAS were symptomatic stenosis/restenosis >70% and asymptomatic stenosis/restenosis >85%. A color duplex scan (CDS) of carotid arteries was performed 6 months after CAS, after 1 year, and annually afterward. Follow-up ranged from 12 to 88 months, with a mean follow-up of 34.6±18.0 months.Results:There were no differences in terms of CR rate between the patients in the CAS (prim) and CAS (res) groups (8.7% vs 7.2%, ?2=0.691, p=0.406). The overall CR rate was 7.9%, whereas significant CR (>70%) rate needing re-intervention was 5.6%, but there was no difference between patients in the CAS (prim) and CAS (res) groups (6.4% vs 4.7%, p=0.351). Six independent predictors for CR were smoking, associated previous myocardial infarction and angina pectoris, plaque morphology, spasm after CAS, the use of FilterWire or Spider Fx cerebral protection devices, and time after stenting. A carotid restenosis risk index (CRRI) was created based on these predictors and ranged from ?7 (minimal risk) to +10 (maximum risk); patients with a score >?4 were at increased risk for CR. There were no differences in terms of neurological and overall morbidity and mortality between the 2 groups.Conclusions:There was no difference in CR rate after CAS between the patients with primary stenosis and restenosis after CEA. A CRRI score >?4 is a criterion for identifying high-risk patients for post-CAS CR that should be tested in future randomized trials. T2 - Journal of Endovascular Therapy T1 - Carotid Restenosis Rate After Stenting for Primary Lesions Versus Restenosis After Endarterectomy With Creation of Risk Index SP - 15266028221091895 DO - 10.1177/15266028221091895 ER -
@article{ author = "Tanasković, Slobodan and Sagić, Dragan Ž. and Radak, Đorđe J. and Antonić, Želimir and Kovačević, Vladimir and Vuković, Mira and Aleksić, Nikola and Radak, Sandra and Nenezić, Dragoslav and Cvetković, Slobodan M. and Isenović, Esma R. and Vučurević, Goran and Lozuk, Branko and Babić, Aleksandar and Babić, Srđan and Matić, Predrag and Gajin, Predrag and Unić-Stojanović, Dragana and Ilijevski, Nenad", year = "2022", abstract = "Purpose: Carotid artery stenting (CAS) is an option for carotid restenosis (CR) treatment with favorable outcomes. However, CAS has also emerged as an alternative to carotid endarterectomy (CEA) for the management of patients with primary carotid stenosis. This study aimed to report CR rates after CAS was performed in patients with primary lesions versus restenosis after CEA, to identify predictors of CR, and to report both neurological and overall outcomes.Materials and methods:From January 2000 to September 2018, a total of 782 patients were divided into 2 groups: The CAS (prim) group consisted of 440 patients in whom CAS was performed for primary lesions, and the CAS (res) group consisted of 342 patients with CAS due to restenosis after CEA. Indications for CAS were symptomatic stenosis/restenosis >70% and asymptomatic stenosis/restenosis >85%. A color duplex scan (CDS) of carotid arteries was performed 6 months after CAS, after 1 year, and annually afterward. Follow-up ranged from 12 to 88 months, with a mean follow-up of 34.6±18.0 months.Results:There were no differences in terms of CR rate between the patients in the CAS (prim) and CAS (res) groups (8.7% vs 7.2%, ?2=0.691, p=0.406). The overall CR rate was 7.9%, whereas significant CR (>70%) rate needing re-intervention was 5.6%, but there was no difference between patients in the CAS (prim) and CAS (res) groups (6.4% vs 4.7%, p=0.351). Six independent predictors for CR were smoking, associated previous myocardial infarction and angina pectoris, plaque morphology, spasm after CAS, the use of FilterWire or Spider Fx cerebral protection devices, and time after stenting. A carotid restenosis risk index (CRRI) was created based on these predictors and ranged from ?7 (minimal risk) to +10 (maximum risk); patients with a score >?4 were at increased risk for CR. There were no differences in terms of neurological and overall morbidity and mortality between the 2 groups.Conclusions:There was no difference in CR rate after CAS between the patients with primary stenosis and restenosis after CEA. A CRRI score >?4 is a criterion for identifying high-risk patients for post-CAS CR that should be tested in future randomized trials.", journal = "Journal of Endovascular Therapy", title = "Carotid Restenosis Rate After Stenting for Primary Lesions Versus Restenosis After Endarterectomy With Creation of Risk Index", pages = "15266028221091895", doi = "10.1177/15266028221091895" }
Tanasković, S., Sagić, D. Ž., Radak, Đ. J., Antonić, Ž., Kovačević, V., Vuković, M., Aleksić, N., Radak, S., Nenezić, D., Cvetković, S. M., Isenović, E. R., Vučurević, G., Lozuk, B., Babić, A., Babić, S., Matić, P., Gajin, P., Unić-Stojanović, D.,& Ilijevski, N.. (2022). Carotid Restenosis Rate After Stenting for Primary Lesions Versus Restenosis After Endarterectomy With Creation of Risk Index. in Journal of Endovascular Therapy, 15266028221091895. https://doi.org/10.1177/15266028221091895
Tanasković S, Sagić DŽ, Radak ĐJ, Antonić Ž, Kovačević V, Vuković M, Aleksić N, Radak S, Nenezić D, Cvetković SM, Isenović ER, Vučurević G, Lozuk B, Babić A, Babić S, Matić P, Gajin P, Unić-Stojanović D, Ilijevski N. Carotid Restenosis Rate After Stenting for Primary Lesions Versus Restenosis After Endarterectomy With Creation of Risk Index. in Journal of Endovascular Therapy. 2022;:15266028221091895. doi:10.1177/15266028221091895 .
Tanasković, Slobodan, Sagić, Dragan Ž., Radak, Đorđe J., Antonić, Želimir, Kovačević, Vladimir, Vuković, Mira, Aleksić, Nikola, Radak, Sandra, Nenezić, Dragoslav, Cvetković, Slobodan M., Isenović, Esma R., Vučurević, Goran, Lozuk, Branko, Babić, Aleksandar, Babić, Srđan, Matić, Predrag, Gajin, Predrag, Unić-Stojanović, Dragana, Ilijevski, Nenad, "Carotid Restenosis Rate After Stenting for Primary Lesions Versus Restenosis After Endarterectomy With Creation of Risk Index" in Journal of Endovascular Therapy (2022):15266028221091895, https://doi.org/10.1177/15266028221091895 . .