SPC365

Carotid artery stenting: a descriptive analysis of a tertiary hospital

Session: Sessão de Posters 01 - Intervenção não valvular
Speaker: Ana L. Silva

Congress: CPC 2024
Topic: H. Interventional Cardiology and Cardiovascular Surgery
Theme: 25. Interventional Cardiology
Subtheme: 25.3 Non-coronary Cardiac Intervention
Session Type: Cartazes
FP Number: ---
Authors: Ana L. Silva; Tatiana Pereira Dos Santos; Mariana Rodrigues Simões; Gonçalo Terleira Batista; Rafaela Fernandes; Vanessa Lopes; Joana Guimarães; Gonçalo Ferraz Costa; Diogo de Almeida Fernandes; José Luís Martins; Marco Costa; Lino Gonçalves

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Introduction:</span></strong><span style="font-size:11.0pt"> Carotid artery stenting (CAS) has emerged as an alternative to carotid endarterectomy&nbsp;for treating atherosclerotic carotid artery stenosis. It is a less invasive technique with several advantages in selected patients.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Purpose:</span></strong><span style="font-size:11.0pt"> The aim of this study was to conduct a comprehensive descriptive analysis of a population who underwent CAS in a tertiary hospital.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Methods:</span></strong> <span style="font-size:11.0pt"><span style="color:black">Single-center, retrospective study. Patients who underwent CAS from 2000 to 2023 were included. A descriptive evaluation of the population characteristics&rsquo; and periprocedural outcomes was conducted. Statistical analysis was performed using SPSS 28.0.1.1 software.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Results:</span></strong><span style="font-size:11.0pt"> Of the 480 patients included (76.4% men, mean age 71.8&plusmn;8.3 years), a substantial proportion exhibited significant cardiovascular risk factors: arterial hypertension (89.6%), dyslipidemia (78.1%), diabetes (33.2%), and a smoking history (28.3%). Over half had coronary artery disease (52.8%), and 21.5% had a history of previous myocardial infarction. Neurologically, 15.5% had experienced a transient ischemic attack(TIA)/amaurosis fugax, and 27.6% had a previous stroke.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:11.0pt">The indications for carotid intervention varied: 41.0% had neurological symptoms, 17.1% had asymptomatic severe stenosis, and 41.8% had it </span><span style="font-size:11.0pt">accomplished </span><span style="font-size:11.0pt">before cardiac surgery (27.8% before </span></span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">coronary artery bypass graft surgery</span></span><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:11.0pt">, 14.0% before valvular surgery). </span><span style="font-size:11.0pt"><span style="color:black">Left and right carotid stenosis were present in 54.7% and 54.2% of patients, with 13.2% displaying bilateral disease. Type 1 aortic arch was the most common (60.6%). Distal filter embolic protection device (EPD) was utilized in 87.0% of cases, while 12.6% used proximal EPD. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:11.0pt"><span style="color:black">Concerning periprocedural complications, hematoma at the puncture site was identified in 2.4%. Acute myocardial infarction occurred in 0.9% of cases and TIA/stroke in 3.4% of cases within the first 24 hours following CAS. During the 30-day follow-up, the combined endpoint of stroke, MI, or death happened in 5.7% of patients. Rates for TIA/stroke, MI, and mortality were 3.7%, 0.9%, and 2.2%, respectively.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Conclusion:</span></strong><span style="font-size:11.0pt"> In experienced centers and feasible cases, carotid artery stenting may be an appropriate alternative to surgical endarterectomy to treat carotid artery stenosis.</span></span></span></p>