Hematological biomarkers for predicting carotid artery vasospasm during carotid stenting.

Yusuf Can, Ibrahim Kocayigit
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Abstract

Introduction: The vasospasm of carotid arteries is important for the progression of neurological sequelae. Many mechanisms have been found to be related to this clinical phenomenon. Predicting this event by using hematological biomarkers may provide opportunities for adopting preventive measures against unfavorable neurovascular complications. The aim of this study is to determine the hematological predictors of carotid artery vasospasm during carotid stenting.

Material and methods: A total of 120 patients who underwent carotid stenting were divided into two groups: those with and without carotid artery vasospasm. Carotid artery vasospasm was angiographically defined as transient or persistent emergent stenosis or irregularity of the vessel wall without evidence of thrombosis during carotid stenting. The hematological parameters were compared between 21 patients who developed carotid artery vasospasm (17.5%) and 99 patients who did not (82.5%).

Results: The mean age of the patients with carotid artery vasospasm and without carotid artery vasospasm was 66 ±8 and 70 ±8 years, respectively. Creatinine levels within 0.5-0.9 (OR = 3.704, 95% CI: 1.245-11.019, p = 0.019), each 1000 unit increase in neutrophil count (OR = 1.567, 95% CI: 1.027-2.392, p = 0.037) and presence of diabetes (OR = 3.081, 95% CI: 1.116-8.505, p = 0.030) were the independent predictors of carotid artery vasospasm in carotid arteries during carotid stenting.

Conclusions: The prediction of carotid artery vasospasm during carotid stenting should help clinicians adopt preventive measures against the development of neurological sequelae. This study found that creatinine levels, increased neutrophil count and presence of diabetes are independent predictors of carotid artery vasospasm.

预测颈动脉支架置入期间血管痉挛的血液学生物标志物。
前言:颈动脉血管痉挛对神经系统后遗症的进展具有重要意义。许多机制已被发现与这一临床现象有关。通过使用血液学生物标志物预测这一事件可能为采取预防措施预防不利的神经血管并发症提供机会。本研究的目的是确定颈动脉支架置入期间颈动脉血管痉挛的血液学预测因素。材料与方法:将120例行颈动脉支架植入术的患者分为颈动脉血管痉挛组和非颈动脉血管痉挛组。颈动脉血管痉挛被血管造影定义为在颈动脉支架置入期间短暂或持续的突发性狭窄或血管壁不规则,无血栓形成的证据。比较21例颈动脉血管痉挛患者(17.5%)和99例未发生颈动脉痉挛患者(82.5%)的血液学参数。结果:颈动脉血管痉挛和非颈动脉血管痉挛患者的平均年龄分别为66±8岁和70±8岁。肌酐水平在0.5-0.9之间(OR = 3.704, 95% CI: 1.245-11.019, p = 0.019),中性粒细胞计数每1000单位增加(OR = 1.567, 95% CI: 1.027-2.392, p = 0.037)和糖尿病的存在(OR = 3.081, 95% CI: 1.116-8.505, p = 0.030)是颈动脉支架置入期间颈动脉血管痉挛的独立预测因子。结论:颈动脉支架植入术中颈动脉血管痉挛的预测有助于临床医生采取预防措施,防止神经系统后遗症的发生。该研究发现肌酐水平、中性粒细胞计数增加和糖尿病的存在是颈动脉血管痉挛的独立预测因子。
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