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Risk factor impact on blood flow velocities and clinical outcomes of stented cervical and intracranial stenoses: preliminary observations.
- Source :
-
Clinical neurology and neurosurgery [Clin Neurol Neurosurg] 2012 Sep; Vol. 114 (7), pp. 922-9. Date of Electronic Publication: 2012 Mar 07. - Publication Year :
- 2012
-
Abstract
- Objectives: The role of angioplasty/stenting procedures, neurointerventionist experience, vascular risk factors, medical treatment and blood flow velocities were analysed to identify possible causes of intra-stent restenosis (ISR) following stenting of cervical and/or intracranial arteries, assuming progressive atherosclerosis to be the shared mechanism in both territories. Patients. 26 cerebrovascular patients subjected to stenting of severe (≥85%) symptomatic or asymptomatic carotid stenoses or moderate-to-severe (≥50%) intracranial or vertebral stenoses were included.<br />Methods: Clinical, radiological and ultrasonographic follow-up data were analysed retrospectively.<br />Results: Overall, stenting of the internal carotid artery (ICA) induced significant reductions in peak systolic velocities at 2 years (96±31 cm/s vs. 358.2±24.9 cm/s at baseline). The procedure-related ischemic complications rate was 7.4% (one hemispheric stroke and one TIA). The rate of ISR≤50% was 8% in the ICA at 2 years; was 50% in the common carotid artery (CCA) at 1 year, with concomitant distal ICA stenosis in 75% of CCA stenting, but all ISR were asymptomatic. Patients with ISR of the ICA were significantly younger (56.8±4.5 vs. 71.3±3.6 years, P=0.042) and had significantly more risk factors (5.5±0.9 vs. 3±0.3, P=0.012). No ISR≥70% was detected.<br />Conclusions: ISR is relatively infrequent and, when present, it is mild and asymptomatic. Restenosis is more frequent in younger patients and those with several risk factors, and it may also be related to stenting of previous carotid endarterectomy.<br /> (Copyright © 2012 Elsevier B.V. All rights reserved.)
- Subjects :
- Aged
Amaurosis Fugax etiology
Angioplasty
Carotid Stenosis physiopathology
Carotid Stenosis surgery
Cerebral Angiography
Clinical Competence
Female
Follow-Up Studies
Graft Occlusion, Vascular epidemiology
Humans
Intracranial Arteriosclerosis physiopathology
Intracranial Arteriosclerosis surgery
Intracranial Embolism prevention & control
Ischemic Attack, Transient etiology
Learning Curve
Male
Middle Aged
Platelet Aggregation Inhibitors therapeutic use
Retrospective Studies
Risk Factors
Stroke etiology
Ultrasonography, Doppler, Duplex
Vascular Surgical Procedures education
Cerebrovascular Circulation
Intracranial Arterial Diseases physiopathology
Intracranial Arterial Diseases surgery
Stents
Vascular Surgical Procedures methods
Subjects
Details
- Language :
- English
- ISSN :
- 1872-6968
- Volume :
- 114
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Clinical neurology and neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 22402202
- Full Text :
- https://doi.org/10.1016/j.clineuro.2012.02.005