Demographic and Technical Risk Factors of 30-Day Stroke, Myocardial Infarction, and/or Death in Standard- and High-Risk Patients Who Underwent Carotid Angioplasty and Stenting.
BACKGROUND
Carotid angioplasty and stenting (CAS) is an accepted treatment to prevent stroke in patients with carotid artery stenosis. The purpose of this study is to identify risk factors for major complications after CAS.


METHODS
This is a prospective study that was conducted at Shiraz University of Medical Sciences in southern Iran from March 2011 to June 2014. Consecutive patients undergoing CAS were enrolled. Both standard- and high-risk patients for endarterectomy were enrolled. Demographic data, atherosclerotic risk factors, site of stenosis, degree of stenosis, and data regarding technical factors were recorded. Thirty-day stroke, myocardial infarction, and/or death were considered as the composite primary outcomes of the study.


RESULTS
A total of 251 patients were recruited (mean age: 71.1 ± 9.6 years; male: 65.3%). Of these, 178 (70.9%) were symptomatic, 73 (29.1%) were diabetic, 129 (51.4%) were hyperlipidemic, 165 (65.7%) were hypertensive, and 62 (24.7%) patients were smokers. CAS was performed for left internal carotid artery (ICA) in 113 (45.4%) patients. Fourteen (5.6%) patients had sequential bilateral stenting. Mean stenosis of operated ICA was 80.2 ± 13.8%. An embolic protection device was used in 203 (96.2%) patients. Pre- and postdilation were performed in 39 (18.5%) and 182 (86.3%) patients, respectively. Composite outcomes were observed in 3.6% of patients (3.2% stroke, 0% myocardial infarction, and 1.2% death). Left-sided lesions and the presence of diabetes mellitus were significantly associated with poor short-term outcome (p = 0.025 and p = 0.020, respectively).


CONCLUSIONS
There was a higher risk of short-term major complications in diabetic patients and for left carotid artery intervention.
Clinical Neurology Research Center, Shiraz University of Medical Sciences, Fasa, Iran ; Department of Neurology, Shiraz University of Medical Sciences, Fasa, Iran.
Afshin
A
Borhani Haghighi
Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.
Samaneh
S
Yousefi
Cardiology Department, Faculty of Medicine, Fasa University of Medical Sciences, Fasa, Iran.
Ehsan
E
Bahramali
Transgenic Technology Research Center, Shiraz University of Medical Sciences, Fasa, Iran.
Safoora
S
Kokabi
Health Policy Research Center, Shiraz University of Medical Sciences, Fasa, Iran.
Seyed Taghi
ST
Heydari
Clinical Neurology Research Center, Shiraz University of Medical Sciences, Fasa, Iran ; Department of Neurology, Shiraz University of Medical Sciences, Fasa, Iran.
Abdolhamid
A
Shariat
Clinical Neurology Research Center, Shiraz University of Medical Sciences, Fasa, Iran ; Department of Neurology, Shiraz University of Medical Sciences, Fasa, Iran.
Alireza
A
Nikseresht
Clinical Neurology Research Center, Shiraz University of Medical Sciences, Fasa, Iran ; Department of Neurology, Shiraz University of Medical Sciences, Fasa, Iran.
Nahid
N
Ashjazadeh
Clinical Neurology Research Center, Shiraz University of Medical Sciences, Fasa, Iran ; Department of Neurology, Shiraz University of Medical Sciences, Fasa, Iran.
Sadegh
S
Izadi
Clinical Neurology Research Center, Shiraz University of Medical Sciences, Fasa, Iran ; Department of Neurology, Shiraz University of Medical Sciences, Fasa, Iran.
Peyman
P
Petramfar
Clinical Neurology Research Center, Shiraz University of Medical Sciences, Fasa, Iran ; Department of Neurology, Shiraz University of Medical Sciences, Fasa, Iran.
Maryam
M
Poursadegh
Clinical Neurology Research Center, Shiraz University of Medical Sciences, Fasa, Iran ; Department of Neurology, Shiraz University of Medical Sciences, Fasa, Iran.
Abbas
A
Rahimi Jaberi
Department of Neurology, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
Sajjad
S
Emami
Shahidzadeh Hospital, Behbahan, Bushehr University of Medical Sciences, Bushehr, Iran.
Hamid
H
Agheli
Department of Neurology, Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.
Reza
R
Nemati
Department of Neurology, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran.
Ehsan
E
Yaghoubi
Motaharri Hospital, Marvdasht, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
Mohammad Hosein
MH
Abdi
Ordibehesht Hospital, Shiraz, Fasa University of Medical Sciences, Fasa, Iran.
Majid
M
Panahandeh
Department of Neurology, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
Moslem
M
Heydari
Department of Pharmacology, Kazeroon Azad University, Kazeroon, Iran.
Anahid
A
Safari
Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran.
Marziyeh
M
Basir
Department of Neurology, Texas Tech University, El Paso, Tex., USA.
Salvador
S
Cruz-Flores
Department of Neurology, Saint Louis University, Saint Louis, Mo., USA ; Department of Psychiatry, Saint Louis University, Saint Louis, Mo., USA.
Randal
R
Edgell
Carotid artery angioplasty and stenting; Cerebrovascular disease; Outcome; Stroke