Incidence of embolism associated with carotid artery stenting: Open-cell versus closed-cell stents

Keun Young Park, Dong Ik Kim, Byung Moon Kim, Hyo Suk Nam, Young Dae Kim, Ji Hoe Heo, Dong Joon Kim

Research output: Contribution to journalArticle

30 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)642-647
Number of pages6
JournalJournal of neurosurgery
Volume119
Issue number3
DOIs
Publication statusPublished - 2013 Sep 1

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Embolism
Carotid Arteries
Stents
Incidence
Carotid Stenosis
Carotid Endarterectomy
Smoking
History
Stroke

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Park, Keun Young ; Kim, Dong Ik ; Kim, Byung Moon ; Nam, Hyo Suk ; Kim, Young Dae ; Heo, Ji Hoe ; Kim, Dong Joon. / Incidence of embolism associated with carotid artery stenting : Open-cell versus closed-cell stents. In: Journal of neurosurgery. 2013 ; Vol. 119, No. 3. pp. 642-647.
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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.",
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Incidence of embolism associated with carotid artery stenting : Open-cell versus closed-cell stents. / Park, Keun Young; Kim, Dong Ik; Kim, Byung Moon; Nam, Hyo Suk; Kim, Young Dae; Heo, Ji Hoe; Kim, Dong Joon.

In: Journal of neurosurgery, Vol. 119, No. 3, 01.09.2013, p. 642-647.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Incidence of embolism associated with carotid artery stenting

T2 - Open-cell versus closed-cell stents

AU - Park, Keun Young

AU - Kim, Dong Ik

AU - Kim, Byung Moon

AU - Nam, Hyo Suk

AU - Kim, Young Dae

AU - Heo, Ji Hoe

AU - Kim, Dong Joon

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N2 - 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.

AB - 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.

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