title: Predictors of periprocedural complications of carotid artery stenting - a multivariate analysis of a single-centre experience.
abstract: BACKGROUND
  Carotid artery stenting (CAS) is currently used as an alternative treatment to carotid endarterectomy (CEA). The objective of this study was to analyse our 5-year experience performing CAS. Secondarily, we sought to determine independent risk factors which predict periprocedural complications.
  
  
  METHODS
  A total of 146 patients who underwent 153 CAS procedures were analysed. The majority of patients (123, 84.2%) had symptomatic carotid stenosis. Demographic and interventional data, angiographic lesion characteristics, and periprocedural complications were recorded. Using univariate and multivariate logistic regression analyses, risk factors associated with adverse clinical outcomes were determined.
  
  
  RESULTS
  Periprocedural neurological complications, including four (2.7 %) major strokes, three (2 %) transient ischaemic attacks, one (0.7%) amaurosis fugax, and two (1.3 %) cases of hyperperfusion syndrome occurred in ten (6.8%) patients. The incidence of periprocedural complications significantly increased in female patients (r = 0.214, p = 0.009) and patients with longer lesions (r = 0.183, p = 0.027), contralateral stenosis ≥50 % (r = 0.222, p = 0.007), the presence of complicated plaques (r = 0.478, p < 0.001) and inadequate glycaemic control (r = 0.259, p = 0.002). Multivariate regression analysis also determined four variables to be potential independent risk factors for 30-day adverse events: higher age (Odds ratio [OR] = 1.283; 95 % CI, 1.051 to 1.566, p = 0.014); longer lesions (OR = 1.459, 95 % CI, 1.124 to 1.893, p = 0.004); higher tortuosity index (OR = 1.015, 95 % CI, 1.001 to 1.030, p = 0.034), and the presence of complicated plaque morphology (OR = 4.321, 95 % CI, 1.621 to 10.23, p = 0.001).
  
  
  CONCLUSIONS
  Patient and lesion characteristics including age, lesion length, complicated plaque morphology and tortuosity index, may be associated with periprocedural complications.
authors.affiliation: 1 Sakarya University Faculty of Medicine, Sakarya, Turkey.
authors.forename: Mehmet Bulent
authors.initials: MB
authors.lastname: Vatan
authors.affiliation: 1 Sakarya University Faculty of Medicine, Sakarya, Turkey.
authors.forename: Bilgehan Atılgan
authors.initials: BA
authors.lastname: Acar
authors.affiliation: 1 Sakarya University Faculty of Medicine, Sakarya, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Aksoy
authors.affiliation: 1 Sakarya University Faculty of Medicine, Sakarya, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Can
authors.affiliation: 1 Sakarya University Faculty of Medicine, Sakarya, Turkey.
authors.forename: Ceyhun
authors.initials: C
authors.lastname: Varım
authors.affiliation: 1 Sakarya University Faculty of Medicine, Sakarya, Turkey.
authors.forename: Mustafa Tarik
authors.initials: MT
authors.lastname: Agac
authors.affiliation: 1 Sakarya University Faculty of Medicine, Sakarya, Turkey.
authors.forename: Harun
authors.initials: H
authors.lastname: Kilic
authors.affiliation: 1 Sakarya University Faculty of Medicine, Sakarya, Turkey.
authors.forename: Ersan
authors.initials: E
authors.lastname: Tatli
authors.affiliation: 1 Sakarya University Faculty of Medicine, Sakarya, Turkey.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Gunduz
authors.affiliation: 1 Sakarya University Faculty of Medicine, Sakarya, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Akdemir
mesh_terms: D000367:Age Factors; D000368:Aged; D017130:Angioplasty / Q000009:adverse effects* / Q000295:instrumentation*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D016009:Chi-Square Distribution; D000072226:Computed Tomography Angiography; D005260:Female; D006801:Humans; D016015:Logistic Models; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome; D014421:Turkey; D018616:Ultrasonography, Doppler, Duplex
keywords: Carotid artery stenting; complications; risk factors; stroke