All-cause, Vascular, and Stroke Mortality in a Midterm Follow-up in Standard and High Risk Patients Having Undergone Carotid Angioplasty and Stenting

Background and Aim: This study presents the risks of all-cause, vascular, and stroke mortality in the mid-term follow up of carotid angioplasty and stenting (CAS) for high and standard risk patients for carotid endarterectomy (CEA). Materials and Methods: Patients with recent ischemic stroke and with >۵۰% stenosis (symptomatic) and with >۸۰% stenosis (asymptomatic) in catheter angiography were included. Follow-up visits were conducted at third month and every ۶ months later. All-cause mortality, vascular mortality (ischemic stroke or hemorrhagic stroke, myocardial infarction, peripheral vascular disease), and stroke attributed to indexed carotid artery were investigated. Results: Two hundred ninety-three (۲۹۳) CAS procedures were documented in the database. Forty-three (۴۳) patients had missed data. Follow-up of ۲۵۰ patients were performed (۶۵.۶ % male, mean age ۷۴ years). The patients were followed ۱-۳۴ months. Out of ۳۶ deaths, ۱۶ (۶.۴%) were cardio-cerebral vascular related deaths, ۲۰ (۸%) non-cardiovascular deaths, and ۹ (۳.۶%) due to unknown reasons. Among vascular deaths, there were ۱۱ ischemic strokes, ۴ hemorrhagic stroke, and one myocardial infarction. The overall survival rate for all-cause mortality was ۹۰.۱% at ۱ year, and ۷۹.۳% at ۲ years and ۵۹.۷% (۴۹.۳ for men and ۸۷.۹ for women) at ۳۴ months. The survival rate for vascular mortality was ۹۴.۴% at one year and ۹۰% at two years and ۸۰.۷ % (۷۳ for men and ۹۷.۶ for women) at ۳۴ months. Male sex was an independent predictor of all-cause mortality (P=۰.۰۰۳) and vascular mortality (P=۰.۰۴۶). Conclusion: CAS may guarantee an acceptable stroke-free survival in high and standard surgical risk patients.

Keywords:

Carotid angioplasty and stenting , Ischemic stroke , Mortality