This Article Full Text Full Text (PDF) All Versions of this Article: 37/10/2557    most recent 01.STR.0000240688.81918.32v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hofmann, R. Articles by Huber, K. Search for Related Content PubMed PubMed Citation Articles by Hofmann, R. Articles by Huber, K. Related Collections Angioplasty and Stenting

(Stroke. 2006;37:2557.)
© 2006 American Heart Association, Inc.

Original Contributions

Risk Score for Peri-Interventional Complications of Carotid Artery Stenting

Robert Hofmann, MD; Alexander Niessner, MD; Alexander Kypta, MD; Clemens Steinwender, MD; Jürgen Kammler, MD; Klaus Kerschner, MD; Michael Grund, MD; Franz Leisch, MD Kurt Huber, MD

From the Cardiovascular Division (R.H., A.K., C.S., J.K., K.K., M.G., F.L.), City Hospital Linz, Austria; the Medical University of Vienna (A.N.), Austria; and the Wilhelminenhospital Vienna (K.H.), Austria.

Correspondence to Dr Robert Hofmann, Cardiovascular Division, City Hospital Linz, Austria, A-4020 Linz, Krankenhausstr. 9. E-mail robert.hofmann{at}akh.linz.at

Background and Purpose— Routinely available independent risk factors for the peri-interventional outcome of patients undergoing elective carotid artery stenting (CAS) are lacking. The rationale of the study was to create a risk score identifying high-risk patients.

Methods— We prospectively enrolled 606 consecutive patients assigned to CAS at a secondary care hospital. Various biochemical, clinical, and lesion-related risk factors were prospectively defined. The primary end point reflecting periprocedural complications encompassed minor and major stroke, nonfatal myocardial infarction and all-cause mortality within 30 days.

Results— Three percent of patients (n=18) experienced a nonfatal minor (n=13) or major (n=5) stroke. 1.3% of patients (n=8) died from fatal stroke (n=4) or other causes (n=4). No myocardial infarction was observed within 30 days after stenting. Multivariable analysis revealed diabetes mellitus with inadequate glycemic control (HbA_1c >7%), age 80 years, ulceration of the carotid artery stenosis, and a contralateral stenosis 50% as independent risk factors. A risk score formed with these variables showed a superior predictive value (C-statistic=0.73) compared with single risk factors. The presence of 2 or more of these risk factors identified patients with a risk of 11% for a periprocedural complication compared with 2% in patients with a score of 0 or 1.

Conclusions— In patients undergoing elective CAS, a risk score based on routinely accessible variables was able to identify patients at high-risk for atherothrombotic events and all-cause death within 30 days after the intervention.

Key Words: carotid stenosis • complications • risk factors

This article has been cited by other articles:

				W. Theiss, P. Hermanek, K. Mathias, H. Bruckmann, J. Dembski, F.-J. Hoffmann, R. Kerner, F. Leisch, H. Mudra, K.-L. Schulte, et al. Predictors of Death and Stroke After Carotid Angioplasty and Stenting: A Subgroup Analysis of the Pro-CAS Data Stroke, August 1, 2008; 39(8): 2325 - 2330. [Abstract] [Full Text] [PDF]

				L. R. Caplan A 70-Year-Old Man With a Transient Ischemic Attack: Review of Internal Carotid Artery Stenosis JAMA, July 2, 2008; 300(1): 81 - 90. [Abstract] [Full Text] [PDF]

				F. W. LoGerfo Carotid Stents: Unleashed, Unproven Circulation, October 2, 2007; 116(14): 1596 - 1601. [Full Text] [PDF]