Impact of coexisting coronary artery disease on the occurrence of cerebral ischemic lesions after carotid stenting
Journal
PLoS ONE
Journal Volume
9
Journal Issue
4
Pages
e94280
Date Issued
2014
Author(s)
Huang, Kuo-Lun; Chang, Yeu-Jhy; Chang, Chien-Hung; Chang, Ting-Yu; Liu, Chi-Hung; Hsieh, I-Chang; Wong, Ho-Fai; Wai, Yau-Yau; Chen, Yu-Wei; Lee, Tsong-Hai
Abstract
Background: Coronary artery disease (CAD) may coexist with extracranial carotid artery stenosis (ECAS), but the influence of CAD on procedure-related complications after carotid artery stenting (CAS) has not been well investigated. The study aimed to determine the impact of CAD on the occurrence of peri-CAS cerebral ischemic lesions on diffusion-weighted imaging (DWI) scanning. Methods: Coronary angiography was performed within six months before CAS. DWI scanning was repetitively done within 1 week before and after CAS. Clinical outcome measures were stroke, angina, myocardial infarction and death within 30 days. Results: Among 126 patients (69.5±9.0 years) recruited for unilateral protected CAS, 33 (26%) patients had peri-CAS DWIpositive lesions. CAD was noted in 79% (26 in 33) and 48% (45 in 93) of patients with and without peri-CAS DWI-positive lesions (OR, 4.0; 95% CI, 1.6-10.0; P = .0018), and the number of concomitant CAD on coronary angiography was positively correlated with the risk for peri-CAS DWI-positive lesions (P = .0032). In patients with no CAD (n = 55), asymptomatic CAD (n = 41) and symptomatic CAD (n = 30), the occurrence rates of peri-CAS DWI-positive lesions were 13%, 41% and 30% (P = .0048), and the peri-CAS stroke rates were 2%, 7% and 0% (P = .2120). Conclusions: The severity of morphological CAD and the presence of either symptomatic or asymptomatic CAD are associated with the occurrence of peri-CAS cerebral ischemic lesions. ? 2014 Huang et al.
SDGs
Other Subjects
antithrombocytic agent; creatinine; age; aged; angina pectoris; angiocardiography; article; asymptomatic disease; brain damage; brain ischemia; cardiovascular risk; carotid artery obstruction; carotid artery stent; carotid artery stenting; cerebrovascular accident; congestive heart failure; controlled study; correlation analysis; creatinine blood level; diffusion weighted imaging; dyslipidemia; female; heart infarction; heart left ventricle ejection fraction; human; hypertension; major clinical study; male; mortality; brain ischemia; carotid artery; complication; coronary artery disease; pathology; stent; Aged; Brain Ischemia; Carotid Arteries; Coronary Artery Disease; Diffusion Magnetic Resonance Imaging; Female; Humans; Male; Stents
Type
journal article