Correlation between carotid vulnerable plaque and adverse occurrence within 30 days of carotid artery stenting

doi:10.3877/cma.j.issn.2095-5782.2016.03.006

Abstract

Abstract:

Objective:

To explore the correlation between carotid vulnerable plaque and undesirable occurrence within 30 days of carotid artery stenting (CAS).

Methods:

A total of 57 cases of carotid stenosis were collected and retrospectively analyzed. These patients were divided into two groups - stable plaque group (group A, n=19) and vulnerable plaque group (group B, n=38). The basic data and postoperative adverse events within 30 days were compared in both groups. The correlation between the vulnerable plaque and adverse events within 30 days of CAS was analyzed by multiple logistic regression analysis.

Results:

Among the 57 cases, 10 had postoperative adverse events within 30 days (17.54%) , including one from group A , and 9 from group B . Four patients (7.01%) experienced ischemic cerebrovascular events (transient ischemic attack, cerebral infarction).Three patients from group B suffered from serious adverse events, including 2 acute cerebral infarction and 1 carotid ulcer plaque rupture bleeding. The multivariate Logistic analysis showed that patients aged ≥65 years (OR=18.789, 95%CI= 1.648-214.220, P=0.018), and with vulnerable plaque (OR=21.806, 95%CI= 1.278-372.177, P=0.033) and an open-cell stent implanted (OR=14.645, 95%CI= 1.407-152.417, P=0.025) were more vulnerable to complications ocurrence within 30 days of CAS.

Conclusion:

Carotid vulnerable plaque is associated with higher adverse events within 30 days of CAS.

Key words: Vulnerable plaque, Carotid artery stenting angioplasty, Adverse event

Qiusong LIU, Xiaofeng HE, Qingle ZENG, Wenya LIU, Quelin MEI. Correlation between carotid vulnerable plaque and adverse occurrence within 30 days of carotid artery stenting[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2016, 04(03): 150-154.

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Figures/Tables 4

References 24

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参数		稳定斑块组（n=19）	易损斑块组（n=38）	χ²值	P值
年龄（岁）		?	?	0.552	0.458
?	<65	11	18	?	?
?	≥65	8	20	?	?
性别		?	?	0.824	0.364
?	男	18	33	?	?
?	女	1	5	?	?
术侧颈动脉		?	?	0.218	0.641
?	左侧	7	16	?	?
?	右侧	11	21	?	?
?	双侧	1	1	?	?
术侧颈动脉狭窄程度		?	?	0.218	0.641
?	中度	4	2	?	?
?	重度	15	36	?	?
颈动脉支架类型		?	?	5.871	0.015
?	开环	13	13	?	?
?	闭环	6	25	?	?
脑保护伞类型		?	?	3.948	0.047
?	无	2	2	?	?
?	FilterWire EZ	6	27	?	?
?	Spider FX	11	9	?	?
颈动脉球囊扩张		?	?	2.961	0.085
?	无	5	20	?	?
?	预扩张	13	16	?	?
?	后扩张	1	2	?	?

参数		稳定斑块组（n=19）	易损斑块组（n=38）	χ²值	P值
年龄（岁）		?	?	0.552	0.458
?	<65	11	18	?	?
?	≥65	8	20	?	?
性别		?	?	0.824	0.364
?	男	18	33	?	?
?	女	1	5	?	?
术侧颈动脉		?	?	0.218	0.641
?	左侧	7	16	?	?
?	右侧	11	21	?	?
?	双侧	1	1	?	?
术侧颈动脉狭窄程度		?	?	0.218	0.641
?	中度	4	2	?	?
?	重度	15	36	?	?
颈动脉支架类型		?	?	5.871	0.015
?	开环	13	13	?	?
?	闭环	6	25	?	?
脑保护伞类型		?	?	3.948	0.047
?	无	2	2	?	?
?	FilterWire EZ	6	27	?	?
?	Spider FX	11	9	?	?
颈动脉球囊扩张		?	?	2.961	0.085
?	无	5	20	?	?
?	预扩张	13	16	?	?
?	后扩张	1	2	?	?

不良事件	稳定斑块组（n=19）	易损斑块组（n=38）	合计
短暂性脑缺血发作	0	2（5.26）	2（3.50）
脑梗塞	0	2（5.26）	2（3.50）
脑过度灌注综合征	0	1（2.63）	1（1.75）
低血压、心动过缓	1（5.26）	3（7.89）	4（7.01）
溃疡斑块破裂出血	0	1（2.63）	1（1.75）

不良事件	稳定斑块组（n=19）	易损斑块组（n=38）	合计
短暂性脑缺血发作	0	2（5.26）	2（3.50）
脑梗塞	0	2（5.26）	2（3.50）
脑过度灌注综合征	0	1（2.63）	1（1.75）
低血压、心动过缓	1（5.26）	3（7.89）	4（7.01）
溃疡斑块破裂出血	0	1（2.63）	1（1.75）

因素	B	SE	Waldχ²	P	OR（95%CI）
年龄（≥65岁）	2.933	1.242	5.580	0.018	18.789（1.648～214.220）
斑块稳定性（易损）	3.082	1.448	4.534	0.033	21.806（1.278～372.177）
支架类型（开环）	2.684	1.195	5.044	0.025	14.645（1.407～152.417）

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