Publication: Impact of aortic arch morphology on periprocedural neurologic events during carotid artery stenting
Issued Date
2018-04-01
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01252208
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2-s2.0-85047126207
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand. Vol.101, No.4 (2018)
Suggested Citation
Nattawut Wongpraparut, Sakaorat Kornbongkotmas, Damras Tresukosol, Viyada Sangsri, Rungtiwa Pongakasira Impact of aortic arch morphology on periprocedural neurologic events during carotid artery stenting. Journal of the Medical Association of Thailand. Vol.101, No.4 (2018). Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/46773
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Title
Impact of aortic arch morphology on periprocedural neurologic events during carotid artery stenting
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Abstract
© 2018, Medical Association of Thailand. All rights reserved. Objective: To investigate the impact of aortic arch morphology on neurologic events and complications during and after carotid artery stenting [CAS]. Materials and Methods: This retrospective study enrolled 130 patients (144 procedures) with symptomatic or asymptomatic carotid stenosis that were treated at our center between January 2006 and December 2013. Results: All 130 patients were at high risk for periprocedural neurologic events and death from carotid endarterectomy [CEA]. Baseline clinical characteristics, angiographic data, procedural characteristics, and periprocedural (30-day) neurologic events were assessed. The primary endpoint was the incidence of periprocedural neurologic events. Thirteen (9%) periprocedural neurologic events were observed, eight (5.5%) of which qualified as major stroke. The periprocedural neurologic events rate was higher in the elderly and occurred in 2.7% of patients with type I arch, 8.1% of patients with type II arch, and 25% of patients with type III arch. Heavily calcified lesion also increased the rate of periprocedural neurologic events. Multivariate analysis identified type III aortic arch (odds ratio [OR] 6.23, p = 0.006), presence of more than 50% common carotid stenosis (OR 4.33, p = 0.035), and heavily calcified lesion (OR 4.15, p = 0.054) as risk factors for a periprocedural event. Conclusion: Type III aortic arch morphology is significantly associated with periprocedural neurologic events during and after CAS.