Carotid Artery Stenting for Recurrent Carotid Artery Restenosis After Previous Ipsilateral Carotid Artery Endarterectomy or Stenting

被引：13

作者：

Hynes, Brian G. ^{[1
]}

Kennedy, Kevin F. ^{[2
]}

Ruggiero, Nicholas J., II ^{[3
]}

Kiernan, Thomas J. ^{[1
]}

Margey, Ronan J. ^{[1
]}

Rosenfield, Kenneth ^{[1
]}

Garasic, Joseph M. ^{[1
]}

机构：

[1] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Cardiol Div,Dept Med, Boston, MA 02114 USA

[2] St Lukes Mid Amer Heart Inst, Kansas City, MO USA

[3] Jefferson Univ Hosp, Dept Intervent Cardiol, Philadelphia, PA USA

来源：

JACC-CARDIOVASCULAR INTERVENTIONS | 2014年 / 7卷 / 02期

关键词：

carotid; endarterectomy; restenosis stenting;

D O I：

10.1016/j.jcin.2013.11.004

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives The purpose of this study was to evaluate and compare outcomes of patients undergoing carotid artery stenting (CAS) for ipsilateral restenosis, after either previous CAS or carotid artery endarterectomy (CEA) (CAS-R group), with those of patients who had CAS performed for de novo carotid atherosclerotic stenosis (CAS-DN group). Background Therapeutic revascularization strategies to reduce stroke include CAS and CEA. Limited data exist concerning the outcomes of CAS in the setting of previous ipsilateral carotid revascularization. Methods Patients enrolled in the CARE (Carotid Artery Revascularization and Endarterectomy) registry who underwent CAS were identified and separated into 2 groups: those undergoing CAS after previous ipsilateral CEA or CAS (CAS-R group, n = 1,996) and those who had CAS performed for de novo atherosclerotic carotid stenosis (CAS-DN group, n = 10,122). We analyzed the clinical and procedural factors associated with CAS-R and CAS-DN between January 1, 2005, and October 8, 2012. Propensity score matching using 19 clinical and 9 procedural characteristics was used, yielding 1,756 patients in each CAS cohort. Results The primary endpoint composite of in-hospital death or stroke or myocardial infarction (MI) occurred less often in the CAS-R compared with CAS-DN patients (1.9% vs. 3.2%; p = 0.019). In-hospital adverse cerebrovascular events (stroke or transient ischemic attack) occurred less frequently in the CAS-R cohort (2.2% vs. 3.6%; p < 0.001). However, there was no significant difference in the composite of death, stroke, or MI at 30 days between both groups. Conclusions Patients who underwent CAS for restenosis after previous ipsilateral revascularization had lower periprocedural adverse event rates and comparable 30-day adverse event rates compared with CAS for de novo carotid artery stenosis. (J Am Coll Cardiol Intv 2014; 7: 180-6) (C) 2014 by the American College of Cardiology Foundation

引用

页码：180 / +

页数：7

共 25 条

[1]

Brott T.G., Halperin J.L., Abbara S., Et al., ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: Executive summary, J Am Coll Cardiol, 57, pp. 1002-1044, (2011)

[2]

Bonati L.H., Ederle J., McCabe D.J., Et al., Long-term risk of carotid restenosis in patients randomly assigned to endovascular treatment or endarterectomy in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): Long-term follow-up of a randomised trial, Lancet Neurol, 8, pp. 908-917, (2009)

[3]

White C.J., Anderson H.V., Brindis R.G., Et al., The Carotid Artery Revascularization and Endarterectomy (CARE) registry: Objectives, design, and implications, Catheter Cardiovasc Interv, 71, pp. 721-725, (2008)

[4]

Yeh R.W., Kennedy K., Spertus J.A., Et al., Do postmarketing surveillance studies represent real-world populations? A comparison of patient characteristics and outcomes after carotid artery stenting, Circulation, 123, pp. 1384-1390, (2011)

[5]

Austin P.C., Optimal caliper widths for propensity-score matching when estimating differences in means and differences in proportions in observational studies, Pharm Stat, 10, pp. 150-161, (2011)

[6]

Austin P.C., Using the standardized difference to compare the prevalence of a binary variable between two groups in observational research, Commun Stat Simulation Comput, 38, pp. 1228-1234, (2009)

[7]

Austin P.C., The performance of different propensity-score methods for estimating relative risks, J Clin Epidemiol, 61, pp. 537-545, (2008)

[8]

Lal B.K., Beach K.W., Roubin G.S., Et al., Restenosis after carotid artery stenting and endarterectomy: A secondary analysis of CREST, a randomised controlled trial, Lancet Neurol, 11, pp. 755-763, (2012)

[9]

Arquizan C., Trinquart L., Touboul P.J., Et al., Restenosis is more frequent after carotid stenting than after endarterectomy: The EVA-3S study, Stroke, 42, pp. 1015-1020, (2011)

[10]

Volteas N., Labropoulos N., Leon M., Kalodiki E., Chan P., Nicolaides A.N., Risk factors associated with recurrent carotid stenosis, Int Angiol, 13, pp. 143-147, (1994)

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