Treatment results of carotid artery stenting in a developing country

This was a retrospective, single-center study conducted on the target group consisting of 65 symptomatic patients who underwent carotid artery stenting. We assessed technical success rate, periprocedural complication within 30 days (hypotension, bradycardia, acute kidney injury, vasospasm, a transient ischemic attack, stroke, myocardial infarction, and death), and the differences between groups with and without complications.

RESULTS:

Minor periprocedural complications occurred in 15 patients. In all, 8 (12.3%) had transient hypotension, 6 (9.2%) had bradycardia, 7 (10.7%) had acute kidney injury, 2 (3.1%) had vasospasm, and 1 (1.5%) had transient ischemic attack. A greater rate of minor complications was observed in women (p=0.051).

CONCLUSION:

The results of the carotid artery stenting procedures performed in a developing country were acceptable.

KEYWORDS:
Risk; Complications; Carotid artery diseases; Stents

Characteristics		n (%)
Male		40 (61.5)
Ethnicity
	White	46 (70.7)
	Black	14(21.5)
	No information	5 (7.7)
Arterial hypertension		50 (76.9)
Diabetes mellitus		25 (38.5)
Cardiopathy		22 (33.8)
Hypercholesterolemia		32 (49.2)
Smoking		28 (43)
Carotid-related stroke		55 (84.6)
Transient ischemic attack		10 (15.4)

Characteristics		Subgroups according to major complications		p-value^a TIA: transient ischemic attack.	Subgroups according to minor complications		p-value^a TIA: transient ischemic attack.
Characteristics		With (%) (n=3)	Without (%) (n=62)	p-value^a TIA: transient ischemic attack.	With (%) (n=15)	Without (%) (n=50)	p-value^a TIA: transient ischemic attack.
Sex (male)		33.3	62.9	0.55	40	68	0.051
Ethnicity (non-white)		33.3	22.8	0.55	21.4	23.9	1.0
Arterial hypertension		66.7	77.4	0.55	80	76	1.0
Diabetes mellitus		33.3	38.7	1.0	46.7	36	0.46
Cardiopathy		33.3	33.8	1.0	33.3	34	0.96
Dyslipidemia		33.3	50	1.0	60	46	0.34
Smoking		33.3	43.5	1.0	60	38	0.13
Previous TIA		33.3	9.7	0.3	6.7	12	1.0
Previous stroke		33.3	25.8	1.0	20	28	0.74
Blood dyscrasia		33.3	3.2	0.13	6.7	2	0.52
Aspirin		66.7	96.8	0.13	93.3	96	0.55
Clopidogrel		66.7	96.8	0.13	86.7	98	0.13
Anticoagulation		50	6.4	0.22	13.3	6	0.32
Type of event
	Stroke	100	83.9	1.0	86.7	84	1.0
	TIA	0	16.1	1.0	13.3	16	1.0

	Worsening in renal function		p-value
	Yes (n=7)	No (n=56)	p-value
Hydration before intervention (%)	85.7	78.6	1.0^a a Fisher’s exact test.
Hydration after intervention (%)	71.4	53.6	0.448^a a Fisher’s exact test.
Treatment with N-acetylcysteine (%)	0	23.2	0.328^a a Fisher’s exact test.
Creatinine at admission (average±standard deviation) (mg/dL)	1.21±1.2	1.02±0.3	0.088^b b Mann-Whitney U test.
Glomerular filtration rate calculated according to CKD-EPI equations, mL/min/1.73 m²2 Roubin GS, New G, Iyer SS, Vitek JJ, Al-Mubarak N, Liu MW, et al. Immediate and late clinical outcomes of carotid artery stenting in patients with symptomatic and asymptomatic carotid artery stenosis: a 5-year prospective analysis. Circulation. 2001;103(4):532-7. https://doi.org/10.1161/01.cir.103.4.532 https://doi.org/10.1161/01.cir.103.4.532... (average±standard deviation)	75.3±30.5	71.7±18.9	0.653^c c Unpaired t-test.

Associação Médica Brasileira R. São Carlos do Pinhal, 324, 01333-903 São Paulo SP - Brazil, Tel: +55 11 3178-6800, Fax: +55 11 3178-6816 - São Paulo - SP - Brazil
E-mail: ramb@amb.org.br

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[1] *Corresponding author: isabella.sales@hc.fm.usp.br; isabella.sales@fm.usp.br