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Incidence of embolism associated with carotid artery stenting: open-cell versus closed-cell stents Clinical article

Authors
 Keun Young Park  ;  Dong Ik Kim  ;  Byung Moon Kim  ;  Hyo Suk Nam  ;  Young Dae Kim  ;  Ji Hoe Heo  ;  Dong Joon Kim 
Citation
 JOURNAL OF NEUROSURGERY, Vol.119(3) : 642-647, 2013 
Journal Title
 JOURNAL OF NEUROSURGERY 
ISSN
 0022-3085 
Issue Date
2013
MeSH
Aged ; Aged, 80 and over ; Carotid Stenosis/complications ; Carotid Stenosis/epidemiology* ; Carotid Stenosis/surgery* ; Embolism/etiology* ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Neurosurgical Procedures/adverse effects* ; Neurosurgical Procedures/standards ; Postoperative Complications/etiology ; Postoperative Complications/pathology ; Stents/adverse effects* ; Stents/classification ; Stents/standards
Keywords
carotid stenosis ; stenting ; embolism ; vascular disorders
Abstract
OBJECT Carotid artery stenting (CAS) can be an alternative option for carotid endarterectomy in the prevention of ischemic stroke caused by carotid artery stenosis. The purpose of this study was to evaluate the influence of stent design on the incidence of procedural and postprocedural embolism associated with CAS treatment. METHODS Ninety-six symptomatic and asymptomatic patients, consisting of 79 males and 17 females, with moderate to severe carotid artery stenosis and a mean age of 69.0 years were treated with CAS. The stent type (48 closed-cell and 48 open-cell stents) was randomly allocated before the procedure. Imaging, procedural, and clinical outcomes were assessed and compared. The symptomatic subgroup (76 patients) was also analyzed to determine the influence of stent design on outcome. RESULTS New lesions on postprocedural diffusion-weighted imaging (DWI) were significantly more frequent in the open-cell than in the closed-cell stent group (24 vs 12, respectively; p = 0.020). The 30-day clinical outcome was not different between the 2 stent groups. In the symptomatic patient group, stent design (p = 0.017, OR 4.173) and recent smoking history (p = 0.036, OR 4.755) were strong risk factors for new lesions on postprocedural DWI. CONCLUSIONS Stent design may have an influence on the risk of new embolism, and selecting the appropriate stent may improve outcome.
Full Text
http://thejns.org/doi/abs/10.3171/2013.5.JNS1331
DOI
10.3171/2013.5.JNS1331
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Ik(김동익)
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Park, Keun Young(박근영)
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87832
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