Post-Procedural Ballooning Doubles Carotid Artery Stenting Death Rate
By HospiMedica International staff writers Posted on 14 Jun 2015 |
A new study shows that combination stent ballooning is associated with increased periprocedural stroke and death rate in carotid artery stenting (CAS).
Researchers at Johns Hopkins University (Baltimore, MD, USA) performed a retrospective analysis involving 3,772 patients who underwent CAS between 2005 and 2014, studying the effect of different pre-SB and post-SB combinations on hemodynamic depression and 30-day stroke and death rate. Patients who had no protection device, those with isolated common carotid artery lesions, and those who had no ballooning at all were excluded. The researchers controlled for age, gender, co-morbidities, smoking, preoperative medications, ipsilateral stenosis, and previous ipsilateral carotid endarterectomy.
The results revealed that while the overall risk of stroke and death was relatively low, with less than 2.4% of patients experiencing a stroke within 30 days of treatment, and less than one percent dying, those treated with a combination pre- and post- SB had a 2.1-fold increase in hemodynamic depression and 2.4-fold increase in perioperative stroke and death rate. The researchers also found that those who had post-SB alone also had an elevated risk, but in the final analysis, it did not reach statistical significance. The study was published on May 30, 2015, in the Journal of Vascular Surgery.
“Although the overall risk of stroke and death is low in patients who undergo carotid stenting, the common practice of ballooning the vessel after the wire mesh is inserted can double the risk of death and stroke during or shortly after the procedure,” said senior author Associate Professor of Surgery Mahmoud Malas, MD, MHS. “The main goal of carotid stenting is not so much to restore blood flow as to contain and stabilize preexisting plaque. Our message is clear: once inside the artery, leave the stent alone.”
Repeat ballooning after stent placement can causes stroke by driving the stent deeper into the fragile vessel walls, disturbing the atherosclerotic plaque and causing emboli to make their way to the brain.
Related Links:
Johns Hopkins University
Researchers at Johns Hopkins University (Baltimore, MD, USA) performed a retrospective analysis involving 3,772 patients who underwent CAS between 2005 and 2014, studying the effect of different pre-SB and post-SB combinations on hemodynamic depression and 30-day stroke and death rate. Patients who had no protection device, those with isolated common carotid artery lesions, and those who had no ballooning at all were excluded. The researchers controlled for age, gender, co-morbidities, smoking, preoperative medications, ipsilateral stenosis, and previous ipsilateral carotid endarterectomy.
The results revealed that while the overall risk of stroke and death was relatively low, with less than 2.4% of patients experiencing a stroke within 30 days of treatment, and less than one percent dying, those treated with a combination pre- and post- SB had a 2.1-fold increase in hemodynamic depression and 2.4-fold increase in perioperative stroke and death rate. The researchers also found that those who had post-SB alone also had an elevated risk, but in the final analysis, it did not reach statistical significance. The study was published on May 30, 2015, in the Journal of Vascular Surgery.
“Although the overall risk of stroke and death is low in patients who undergo carotid stenting, the common practice of ballooning the vessel after the wire mesh is inserted can double the risk of death and stroke during or shortly after the procedure,” said senior author Associate Professor of Surgery Mahmoud Malas, MD, MHS. “The main goal of carotid stenting is not so much to restore blood flow as to contain and stabilize preexisting plaque. Our message is clear: once inside the artery, leave the stent alone.”
Repeat ballooning after stent placement can causes stroke by driving the stent deeper into the fragile vessel walls, disturbing the atherosclerotic plaque and causing emboli to make their way to the brain.
Related Links:
Johns Hopkins University
Latest Surgical Techniques News
- Miniaturized Implantable Multi-Sensors Device to Monitor Vessels Health
- Tiny Robots Made Out Of Carbon Could Conduct Colonoscopy, Pelvic Exam or Blood Test
- Miniaturized Ultrasonic Scalpel Enables Faster and Safer Robotic-Assisted Surgery
- AI Assisted Reading Tool for Small Bowel Video Capsule Endoscopy Detects More Lesions
- First-Ever Contact Force Pulsed Field Ablation System to Transform Treatment of Ventricular Arrhythmias
- Caterpillar Robot with Built-In Steering System Crawls Easily Through Loops and Bends
- Tiny Wraparound Electronic Implants to Revolutionize Treatment of Spinal Cord Injuries
- Small, Implantable Cardiac Pump to Help Children Awaiting Heart Transplant
- Gastrointestinal Imaging Capsule a Game-Changer in Esophagus Surveillance and Treatment
- World’s Smallest Laser Probe for Brain Procedures Facilitates Ablation of Full Range of Targets
- Artificial Intelligence Broadens Diagnostic Abilities of Conventional Coronary Angiography
- AI-Powered Surgical Visualization Tool Supports Surgeons' Visual Recognition in Real Time
- Cutting-Edge Robotic Bronchial Endoscopic System Provides Prompt Intervention during Emergencies
- Handheld Device for Fluorescence-Guided Surgery a Game Changer for Removal of High-Grade Glioma Brain Tumors
- Porous Gel Sponge Facilitates Rapid Hemostasis and Wound Healing
- Novel Rigid Endoscope System Enables Deep Tissue Imaging During Surgery