High-risk anatomic variables and plaque characteristics in carotid artery stenting

Courtney E. Morgan, Cheong J. Lee, Jason A. Chin, Mark K. Eskandari, Mark D. Morasch, Heron E. Rodriguez, Irene B. Helenowski, Melina R. Kibbe*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Objectives: To determine anatomic and plaque-related risk factors for patients undergoing carotid artery stenting. Methods: A retrospective review of patients from a prospectively maintained database undergoing carotid artery stenting at our institution between 2001 and 2010 was performed. Preoperative imaging studies (ie, ultrasound, computed tomography angiography, magnetic resonance angiography, and angiograms) were reviewed for specific anatomic criteria and plaque characteristics. Primary outcomes included 30-day stroke or transient ischemic attack (TIA). Secondary outcomes included 30-day death and myocardial infarction (MI). Statistical significance was assumed for P = .05. Results: Imaging was reviewed for 381 carotid arteries in 375 patients. There were 14 (3.7%) perioperative neurologic events, which included 8 TIA and 6 strokes. Thirty-day mortality and MI were 0.5% and 0.75%, respectively. Degree of internal carotid artery stenosis was associated with primary outcomes (P = .03), and the presence of arch calcification trended toward an increase in primary outcomes (P = .07). However, arch type, ostial involvement, tandem lesions, and plaque calcification did not correlate with primary outcomes. Differences were noted between the sexes, with females having more common carotid artery tortuosity than males (34% vs 27%, P = .04). Females also had a trend toward more plaque calcification and more severe arch calcification than males. These differences did not translate to differences in perioperative neurologic events. Conclusion: Our data suggest that degree of internal carotid artery stenosis and aortic arch calcification may be associated with increased perioperative neurologic risk during carotid stenting, but arch type is not.

Original languageEnglish (US)
Pages (from-to)452-459
Number of pages8
JournalVascular and Endovascular Surgery
Volume48
Issue number7-8
DOIs
StatePublished - Jan 1 2014

Keywords

  • Arch type
  • Calcification
  • Carotid artery
  • Carotid artery stenting

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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