Hong Jeong-Ho, Kang Jihoon, Yeo Min-Ju, Kim Beom Joon, Jang Min Uk, Bae Hee-Joon, Kwon O-Ki, Hwang Gyo Jun, Oh Chang Wan, Jung Cheolkyu, Lee Ji Sung, Han Moon-Ku
Department of Neurology, Keimyung University Dongsan Medical Center, Daegu, Korea.
Cardiovasc Intervent Radiol. 2015 Apr;38(2):280-7. doi: 10.1007/s00270-014-0917-y. Epub 2014 Jun 14.
Carotid endarterectomy and stenting are used to treat carotid stenosis, with the volume of carotid artery procedures increasing over the past decade. We investigated the 10-year trend of periprocedural complications with an increasing procedure volume of carotid stenting at a single tertiary hospital.
We collected 416 consecutive cases (384 patients) of carotid artery stenting performed for either symptomatic (231 cases, 55.5 %) or asymptomatic (185 cases, 44.5 %) internal carotid artery stenosis at a single center. Periprocedural complication was defined as any stroke, myocardial infarction, or death. Procedure-related outcome included any dissection, hemodynamic event, or periprocedural complication.
The mean age was 68.8 years (82.8 % males; range of 20-89 years); 23.9 % were older than 75 years. Before the procedure, 99.3 and 56.0 % of patients received antiplatelet and lipid-lowering medication, respectively. The overall periprocedural complication rate was 3.6 % (1.6 and 5.2 % in the asymptomatic and symptomatic group, respectively). The composite outcome of any stroke or death was 3.4 %. Periprocedural complication and procedure-related outcome showed a decremental trend with increasing procedure volume, and this trend remained after adjusting for confounders.
Our study suggests that carotid stenting at an experienced center might reduce the periprocedural complications. Our periprocedural complication rate of carotid artery stenting may be comparable to, or somewhat lower than, that reported in other clinical trials.
颈动脉内膜切除术和支架置入术用于治疗颈动脉狭窄，在过去十年中颈动脉手术量不断增加。我们在一家单一的三级医院研究了随着颈动脉支架置入术手术量增加围手术期并发症的10年趋势。
我们收集了在单一中心连续进行的416例（384例患者）颈动脉支架置入术病例，这些病例用于治疗有症状（231例，55.5%）或无症状（185例，44.5%）的颈内动脉狭窄。围手术期并发症定义为任何中风、心肌梗死或死亡。与手术相关的结果包括任何夹层、血流动力学事件或围手术期并发症。
平均年龄为68.8岁（男性占82.8%；年龄范围为20 - 89岁）；23.9%的患者年龄超过75岁。手术前，分别有99.3%和56.0%的患者接受了抗血小板和降脂药物治疗。总体围手术期并发症发生率为3.6%（无症状组和有症状组分别为1.6%和5.2%）。任何中风或死亡的综合结果为3.4%。围手术期并发症和与手术相关的结果随着手术量增加呈下降趋势，在调整混杂因素后这一趋势仍然存在。
我们的研究表明，在经验丰富的中心进行颈动脉支架置入术可能会降低围手术期并发症。我们的颈动脉支架置入术围手术期并发症发生率可能与其他临床试验报告的相当，或略低于其他临床试验报告的发生率。
