Background: This study was conducted to identify the prevalence, risk factors, and clinical relevance of carotid artery stentfracture.Methods: Commercially available carotid stents were implanted in this prospective, observational study that began inJanuary 2004. Indications included asymptomatic patients (stenosis >80%), symptomatic patients (stenosis >60%), andulcerated lesions (>50%). Stent integrity was assessed with plain radiography at 12 months. Data were analyzed in April2009 on a series of 341 consecutive patients treated with carotid artery stenting with at least 12 months follow-up.Results: Stent fracture prevalence was 3.4% at 12 months (95% confidence interval, 1.7%-6.1%). The median clinicalfollow-up was 30 months (range, 12-64 months) for 323 eligible patients. Treatment included 23.6% of symptomaticpatients. According to univariate analysis, calcification type III increased the odds of stent fracture by more than 4.5 times(odds ratio [OR], 4.74; P .006) and angulation >45° increased the odds of stent fracture by 6.5 times (OR, 6.51; P .008). Carotid stent cell type, stent length, and stent over-sizing were not correlated with stent fracture incidence. Stentfracture was not associated with stroke (0%), transient ischemic attack (0%), or death (0%). Restenosis was significantlyassociated with stent fracture (P < .001). Multivariate analysis evidenced that type III calcification (OR, 3.90; P .029)and angulation >45° (OR, 4.69; P .026) were important risk factors for carotid stent fracture.Conclusions: Carotid stent fracture is a rare complication after CAS and is associated with vessel angulation, calcification,and restenosis. In this series, fracture identification was independent of stroke, transient ischemic attack, and mortality.

Carotid artery stent fracture identification and clinical relevance / Coppi, Gioachino; Moratto, R.; Veronesi, J.; Nicolosi, E.; Silingardi, R.. - In: JOURNAL OF VASCULAR SURGERY. - ISSN 0741-5214. - ELETTRONICO. - 51:(2010), pp. 1397-1405. [10.1016/j.jvs.2010.02.009]

Carotid artery stent fracture identification and clinical relevance

COPPI, Gioachino;R. Silingardi
2010

Abstract

Background: This study was conducted to identify the prevalence, risk factors, and clinical relevance of carotid artery stentfracture.Methods: Commercially available carotid stents were implanted in this prospective, observational study that began inJanuary 2004. Indications included asymptomatic patients (stenosis >80%), symptomatic patients (stenosis >60%), andulcerated lesions (>50%). Stent integrity was assessed with plain radiography at 12 months. Data were analyzed in April2009 on a series of 341 consecutive patients treated with carotid artery stenting with at least 12 months follow-up.Results: Stent fracture prevalence was 3.4% at 12 months (95% confidence interval, 1.7%-6.1%). The median clinicalfollow-up was 30 months (range, 12-64 months) for 323 eligible patients. Treatment included 23.6% of symptomaticpatients. According to univariate analysis, calcification type III increased the odds of stent fracture by more than 4.5 times(odds ratio [OR], 4.74; P .006) and angulation >45° increased the odds of stent fracture by 6.5 times (OR, 6.51; P .008). Carotid stent cell type, stent length, and stent over-sizing were not correlated with stent fracture incidence. Stentfracture was not associated with stroke (0%), transient ischemic attack (0%), or death (0%). Restenosis was significantlyassociated with stent fracture (P < .001). Multivariate analysis evidenced that type III calcification (OR, 3.90; P .029)and angulation >45° (OR, 4.69; P .026) were important risk factors for carotid stent fracture.Conclusions: Carotid stent fracture is a rare complication after CAS and is associated with vessel angulation, calcification,and restenosis. In this series, fracture identification was independent of stroke, transient ischemic attack, and mortality.
51
1397
1405
Carotid artery stent fracture identification and clinical relevance / Coppi, Gioachino; Moratto, R.; Veronesi, J.; Nicolosi, E.; Silingardi, R.. - In: JOURNAL OF VASCULAR SURGERY. - ISSN 0741-5214. - ELETTRONICO. - 51:(2010), pp. 1397-1405. [10.1016/j.jvs.2010.02.009]
Coppi, Gioachino; Moratto, R.; Veronesi, J.; Nicolosi, E.; Silingardi, R.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/644699
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