Treatment results of carotid artery stenting in a developing country

Macêdo, Isabella Sales de; Alquères, Rafaela Almeida; Viana, Lorena Souza; Puglia Júnior, Paulo; Conforto, Adriana Bastos

doi:10.1590/1806-9282.20220525

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Original Article • Rev. Assoc. Med. Bras. 69 (4) • 2023 • https://doi.org/10.1590/1806-9282.20220525 linkcopy

Treatment results of carotid artery stenting in a developing country

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE: The purpose of this study was to investigate the details of minor complications of carotid artery stenting in a developing country.

METHODS: This was a retrospective, single-center study conducted on the target group consisting of 65 symptomatic patients who underwent carotid artery stenting. We assessed technical success rate, periprocedural complication within 30 days (hypotension, bradycardia, acute kidney injury, vasospasm, a transient ischemic attack, stroke, myocardial infarction, and death), and the differences between groups with and without complications.

RESULTS: Minor periprocedural complications occurred in 15 patients. In all, 8 (12.3%) had transient hypotension, 6 (9.2%) had bradycardia, 7 (10.7%) had acute kidney injury, 2 (3.1%) had vasospasm, and 1 (1.5%) had transient ischemic attack. A greater rate of minor complications was observed in women (p=0.051).

CONCLUSION: The results of the carotid artery stenting procedures performed in a developing country were acceptable.

KEYWORDS:
Risk; Complications; Carotid artery diseases; Stents

Characteristics		n (%)
Male		40 (61.5)
Ethnicity
	White	46 (70.7)
	Black	14(21.5)
	No information	5 (7.7)
Arterial hypertension		50 (76.9)
Diabetes mellitus		25 (38.5)
Cardiopathy		22 (33.8)
Hypercholesterolemia		32 (49.2)
Smoking		28 (43)
Carotid-related stroke		55 (84.6)
Transient ischemic attack		10 (15.4)

Characteristics		Subgroups according to major complications		p-valuea	Subgroups according to minor complications		p-valuea
Characteristics		With (%) (n=3)	Without (%) (n=62)	p-valuea	With (%) (n=15)	Without (%) (n=50)	p-valuea
Sex (male)		33.3	62.9	0.55	40	68	0.051
Ethnicity (non-white)		33.3	22.8	0.55	21.4	23.9	1.0
Arterial hypertension		66.7	77.4	0.55	80	76	1.0
Diabetes mellitus		33.3	38.7	1.0	46.7	36	0.46
Cardiopathy		33.3	33.8	1.0	33.3	34	0.96
Dyslipidemia		33.3	50	1.0	60	46	0.34
Smoking		33.3	43.5	1.0	60	38	0.13
Previous TIA		33.3	9.7	0.3	6.7	12	1.0
Previous stroke		33.3	25.8	1.0	20	28	0.74
Blood dyscrasia		33.3	3.2	0.13	6.7	2	0.52
Aspirin		66.7	96.8	0.13	93.3	96	0.55
Clopidogrel		66.7	96.8	0.13	86.7	98	0.13
Anticoagulation		50	6.4	0.22	13.3	6	0.32
Type of event
	Stroke	100	83.9	1.0	86.7	84	1.0
	TIA	0	16.1	1.0	13.3	16	1.0

	Worsening in renal function		p-value
	Yes (n=7)	No (n=56)	p-value
Hydration before intervention (%)	85.7	78.6	1.0a
Hydration after intervention (%)	71.4	53.6	0.448a
Treatment with N-acetylcysteine (%)	0	23.2	0.328a
Creatinine at admission (average±standard deviation) (mg/dL)	1.21±1.2	1.02±0.3	0.088b
Glomerular filtration rate calculated according to CKD-EPI equations, mL/min/1.73 m² (average±standard deviation)	75.3±30.5	71.7±18.9	0.653c

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[TFN1] TIA: transient ischemic attack.

[TFN2] ^a
Chi-square or Fisher’s exact test.