Risk Factors and Complications Associated with Carotid Artery Stenting: A Retrospective Study

Corresponding author: Tae-Sik Gong Department of Neurosurgery, Presbyterian Medical Center, 365, Seowon-ro, Wansan-gu, Jeonju 54987, Republic of Korea Tel: +82-63-230-1420 Fax: +82-63-230-1429 E-mail: nskts@hanmail.net Objective: The use of selective carotid stents to reduce ipsilateral stroke in patients with cerebral artery stenosis has been increasing recently. The insertion of carotid stents can cause complications of embolism, and many efforts are involved to reduce such effects. This study investigated the risk factors and complications by examining 125 cases that underwent carotid artery stenting (CAS) in a single center in the past 5 years. Methods: The prognosis of 125 patients who underwent CAS in the past 5 years was evaluated by considering the following 2 outcomes: postprocedure symptomatic events and stroke or other vascular problems (SOVP). The prognosis also considered the following: non-modifiable factors, such as age and sex; modifiable factors, such as a smoking history, hypertension, and diabetes; and magnetic resonance imaging changes that occurred after CAS. Results: In this study, an age above 80 years (p=0.031) and a history of cerebrovascular accidents (p=0.016) were identified as the significant risk factors for the incidence of stroke among patients after stent insertion. The presence of a distal filter device and the type of maintenance therapy administered before and after CAS (aspirin, clopidogrel, or aspirin+clopidogrel) exhibited no significant effects on post-procedure outcomes. Conclusion: This study indicated that 2.6% of stroke symptoms are directly related to CAS and that 3.2% of SOVP occurred within 30 days after the procedure. Patients above the age of 80 or with a history of stroke should be fully informed of the risk factors and side effects of CAS procedures.