The interval between carotid artery stenting and open heart surgery is related to perioperative complications

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Abstract

Objectives:

To assess 30-day outcomes and the optimal interval between carotid artery stenting (CAS) and open heart surgery (OHS).

Background:

Whether or not they show symptoms of carotid atherosclerosis, patients with significant carotid stenosis who underwent OHS face a high risk of perioperative stroke. Planning appropriate treatment for carotid stenosis before OHS has become an important clinical issue.

Methods:

From January 2005 to June 2010, 154 inpatients scheduled for CAS and OHS were recruited and followed up for 30 days after OHS. The primary end point was a composite of major stroke or neurological death. The secondary end points included a composite of major stroke, myocardial infarction (MI) or any death, minor stroke, and acute kidney injury (AKI).

Results:

The incidence of the primary end point, the composite of major stroke, MI or any death, minor stroke and AKI was 3.2%, 5.8%, 2.6%, and 4.5%, respectively. Only an interval between CAS and OHS of ≤5 days could independently predict the incidence of the primary end point (OR, 14.06, 95% CI, 1.52-130.13;P=0.020). Moreover, congestive heart failure (OR, 7.07, 95% CI, 1.55-21.27;P=0.012) and an interval between CAS and OHS of ≤5 days (OR, 7.05, 95% CI, 1.58-31.40;P=0.010) were identified as independent risk factors for the composite of major stroke, MI, or any death.

Conclusions:

Our findings indicate that CAS followed by OHS is safe and feasible. More importantly, an interval between CAS and OHS of >5 days may decrease periprocedural complications, especially major stroke and neurological death. © 2016 Wiley Periodicals, Inc.

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