Introduction: Statin therapy has shown to induce carotid atherosclerotic plaque regression and reduce the incidence of the periprocedural ischemic complications with carotid artery stenting (CAS).
Hypothesis: Pretreatment of high-dose strong statin can reduce the periprocedural ischemic complications with CAS comparing with conventional statin therapy.
Methods: We analyzed the safety and usefulness of pretreatment of high-dose strong statin with CAS. We analyzed 117 carotid lesions treated by CAS and evaluated with magnetic resonance imaging (MRI) within 48 hours after the procedure. In 67 lesions, high-dose strong statin (rosuvastatin 20mg or atorvastatin 40mg daily) were prescribed more than two weeks before CAS for over 1 month (HDSS group). Clinical and angiographic data, as well as in-hospital outcomes, of the HDSS group were retrospectively compared with 50 lesions who had conventional treatment without high-dose strong statin (non-HDSS group).
Results: There were no significant differences in the baseline clinical and angiographic characteristics between the two groups. Stroke rates were similar between the two groups (3.0% in HDSS group vs 8.0% in non-HDSS group, p=0.2238). All were minor strokes. Compared to the non-HDSS group, the HDSS group had less frequencies of new lesions on diffusion-weighted imaging (DWI) with MRI (25.4% vs 44.0%, p=0.0345). New ipsilateral DWI-positive rate in HDSS group was significantly lower than in non-HDSS group (16.4% vs 34.0%, p=0.0275). Nonipsilateral (contralateral or posterior circulation) DWI-positive rates were similar between the two groups (13.4% vs 20.0%, p=0.3407).
Conclusions: Pretreatment with high-dose strong statin significantly reduced the periprocedural ischemic complications with CAS.