title: Early treatment after a symptomatic event is not associated with an increased risk of stroke in patients undergoing carotid stenting.
abstract: A recently symptomatic carotid artery stenosis carries a high risk of subsequent ischaemic events and thus requires rapid treatment. We investigated the influence of the time delay between the last symptomatic event of a carotid stenosis and subsequent carotid artery stenting (CAS) with respect to the combined 30-day outcome of stroke and death. In a group of 320 patients undergoing CAS the median delay before the intervention was 19 days (interquartile range 10-36) and the combined 30-day complication rate was 8.4%. Time delay was not significantly associated with peri-procedural complications, regardless of whether this variable was dichotomized (<14 days and > or =14 days), separated into interquartile ranges or analysed as a continuous variable. Our results indicate that early CAS is not associated with an increased complication rate in patients with a recently symptomatic carotid stenosis. Thus, if CAS has been selected as the treatment modality for a patient, it should be performed as soon as possible to maximize the benefit of the intervention in reducing the risk of stroke.
authors.affiliation: Department of Neurology, University of Göttingen, Göttingen, Germany. klaus.groeschel@medizin.uni-goettingen.de
authors.forename: K
authors.initials: K
authors.lastname: Gröschel
authors.forename: M
authors.initials: M
authors.lastname: Knauth
authors.forename: U
authors.initials: U
authors.lastname: Ernemann
authors.forename: S M
authors.initials: SM
authors.lastname: Pilgram
authors.forename: S
authors.initials: S
authors.lastname: Schnaudigel
authors.forename: A
authors.initials: A
authors.lastname: Kastrup
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D016893:Carotid Stenosis / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D004632:Emergency Medical Services / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects* / Q000706:statistics & numerical data; D020521:Stroke / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D013997:Time Factors; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000706:statistics & numerical data