Early treatment after a symptomatic event is not associated with an increased risk of stroke in patients undergoing carotid stenting

Eur J Neurol. 2008 Jan;15(1):2-5. doi: 10.1111/j.1468-1331.2007.02002.x. Epub 2007 Nov 14.

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.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Ischemia / complications
  • Brain Ischemia / physiopathology
  • Brain Ischemia / therapy*
  • Carotid Stenosis / complications
  • Carotid Stenosis / physiopathology
  • Carotid Stenosis / therapy*
  • Emergency Medical Services / standards
  • Emergency Medical Services / statistics & numerical data
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Risk Factors
  • Stents / adverse effects*
  • Stents / statistics & numerical data
  • Stroke / etiology
  • Stroke / physiopathology
  • Stroke / prevention & control*
  • Time Factors
  • Vascular Surgical Procedures / adverse effects*
  • Vascular Surgical Procedures / statistics & numerical data