Abstract W P113: Periprocedural Risk of Carotid Revascularization According to Delay from Neurologic Symptom Onset During the Acute Period
Background: Concerns on procedural risks in patients with recent transient ischemic attack (TIA) or stroke have been raised against the efficacy of early carotid revascularization performed during the acute period (<15-20days) from neurologic symptoms onset. Aim of this study was to define the 30-day risks of stroke/death after carotid endarterectomy (CEA) and carotid stenting (CAS) in symptomatic patients stratified for delay from the last neurologic event.
Methods: During 2009-2013, 207 consecutive patients were treated with carotid revascularization within 20 days from the last neurologic event. Thirty-day stroke/death rate was analyzed in procedures performed <48h, during the first 7 days, between 7 and 15 days or after 15 days.
Results: There were 183 CEA and 24 CAS. Overall 175 procedures were performed within the first 15 days and 32 after. Specifically, 22 patients were treated within the first 48h and 89 within the first 7 days. The 30-day stroke and death rate was 2.9% (6/207). There were 3 deaths, 2 cerebral hemorrhages and 3 ischemic strokes. 30-day stroke/death rate was comparable in patients treated within the first 15 days and those treated later : 2.9% (5/175) and 3.1% (1/32); Odds ratio , OR 0.9; 95%Confidence Interval, CI, 0.10-8.1; p=.99. 30-day stroke/death rate was 2.2% (2/89) for patients treated within 7 days and 3.5% (3/86) for those treated between 7 and 15 days. For the 22 patients receiving carotid revascularization within the first 48 hours, periprocedural risk was 0.
Conclusions: Currently carotid revascularization can be performed safely within the acute period from neurologic symptoms onset with a stroke/death risk of 3.5% or lower.
Author Disclosures: P. De Rango: None. M. Lenti: None. E. Cieri: None. A. Ciucci: None. L. Farchioni: None. B. Fiorucci: None. V. Caso: None.
- © 2014 by American Heart Association, Inc.