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- W2995041874 abstract "Introduction - Patients with a symptomatic carotid artery stenosis risk a recurrent ischemic event during the waiting time to intervention or in the perioperative period. As the risk of recurrence is highest in the early phase after the presenting event, recent strategies recommend short delay to intervention but there are concerns that the possible benefit from early intervention may be counterbalanced by an increased perioperative complication rate. The aim of this national audit was to study the effects of more expedient carotid intervention on the risk of recurrent ischemic events. Methods - The Swedish Vascular Registry (Swedvasc) covers all centers in the country performing carotid interventions, and all registrations for symptomatic carotid artery stenosis from May 2008 to December 2015 were analyzed, focusing on recurrent ischemic events in the delay to surgical intervention and during the 30-day perioperative follow-up. The National Prescribed Drug Registry provided data on preventive medications prior to hospitalization for the carotid procedure. Results - In Swedvasc 6814 procedures for symptomatic carotid stenosis were registered during the time period. The mean age was 72 (±8) years and 68% were male. The presenting events were TIA in 58%, amaurosis fugax in 22% and stroke in 20%. Baseline demographic variables, comorbidities and secondary prevention pharmacotherapy when admitted for the procedure was similar during study period. The waiting time from the presenting neurological event to carotid intervention decreased from 13 (IQR 6-27) to 7 days (IQR 4-12) during the study period. Importantly, the proportion of recurrent ischemic events decreased over time from 30% (CI 28-33%) in 2008-2009 to 21% (CI 19–23%) in 2014-2015 (p< 0.01, χ2test). The perioperative stroke and/or death rate was 3.6%, with a decreasing trend during study period (5.3% 2008-2009 vs. 3.2% 2014-2015, p=0.05). Conclusion - In this population-based study, the overall risk for a recurrent ischemic event, from the presenting event until the 30-day follow-up, was markedly decreased during the time period. Efforts in reducing the delay to surgery were not counterbalanced by any increase in the perioperative complication rate." @default.
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- W2995041874 date "2019-12-01" @default.
- W2995041874 modified "2023-09-30" @default.
- W2995041874 title "Reduced Recurrent Ischemic Event Rate for Patients Undergoing Invasive Carotid Artery Intervention" @default.
- W2995041874 doi "https://doi.org/10.1016/j.ejvs.2019.06.877" @default.
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