Ces radiol. 2024, 78(1):18-26 | DOI: 10.55095/CesRadiol2024/003

Carotid artery stenting: influence of tailored antiplatelet therapyOriginal article

Pavol Vigláš^1,2, Vojtěch Smolka¹, Jan Raupach², Aleš Hejčl³, David Černík⁴, Filip Cihlář¹

¹ Radiologická klinika Fakulty zdravotnických studií UJEP a Krajské zdravotní a.s. - Masarykova nemocnice v Ústí nad Labem, o.z.

² Radiologická klinika LF UK a FN, Hradec Králové

³ Neurochirurgická klinika Fakulty zdravotnických studií UJEP a Krajské zdravotní a.s. - Masarykova nemocnice v Ústí nad Labem, o.z.

⁴ Neurologické oddělení, Krajská zdravotní a.s. - Masarykova nemocnice v Ústí nad Labem, o.z.

Aim: The aim of the work is to analyze the results of carotid stenting in ourgroup of patients routinely tested for the effectiveness of dual antiplatelettherapy. We compare the results with data from randomized controlled trials.

Methods: Retrospective analysis of results of carotid stenting performed atthe Radiology in the Masaryk Hospital in Ústí nad Labem from 2014 to 2022. 241patients who were not suitable for surgical treatment underwent carotidstenting. The set of consecutive patients is specific for the setting ofeffective antiplatelet therapy in the preprocedural period. The monitoredperiod is within 30 days after the intervention.

Results: We treated 179 men (74.2%) and 62 women (25.8%). Five patients (2%)suffered a periprocedural stroke (CMP) during the monitored period, two (0.8%)died from a complication directly related to the procedure. Three patientsdied of a cause unrelated to the intervention (1.2%). We did not encounter amyocardial infarction. The risk of periprocedural death or stroke in theentire cohort was significantly lower compared to the results of the CRESTstudy (2.0% vs. 4.8%, p = 0.0243). In the group of symptomatic patients,periprocedural death or stroke was significantly lower compared to the ICSSstudy (2.9% vs. 7.4%, p = 0.0243).

Conclusion: In our group of patients, who were unsuitable for surgicaltreatment of carotid stenosis, we evaluated the effectiveness of antiplatelettherapy in carotid stenting. The risk of periprocedural death or CMP wasstatistically significantly lower than in the CREST or the ICSS study. Theresults demonstrate that routine testing of antiplatelet therapy is safe andmay reduce the risk of stroke and periprocedural death.

Keywords: antiplatelet therapy, carotid stenosis, carotid stenting

Grants and funding:

Práce byla podpořena grantem Krajské zdravotní a.s. IGA-KZ-2023-1-10.

Published: March 1, 2024  Show citation