ArticleJournal of vascular surgery2021
Outcomes after transfemoral carotid artery stenting stratified by preprocedural symptom status.
Article in Journal of vascular surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Systematic Review and Meta-analysis of Radial or Femoral Access for Carotid Stenting.Clinical neuroradiology · 2024Pooled it
- Rethinking the impact of amaurosis with contemporary outcomes of carotid endarterectomy among patients with transient monocular blindness.Journal of vascular surgery · 2026Article
- Factors associated with restenosis after carotid artery stenting differ between closed-cell and open-cell stents.Frontiers in neurology · 2025Article
- Seven years of the transcarotid artery revascularization surveillance project, comparison to transfemoral stenting and endarterectomy.Journal of vascular surgery · 2024Article
- Transradial Access Versus Transfemoral Approach for Carotid Artery Stenting: A Systematic Review and Meta-Analysis.Stroke (Hoboken, N.J.) · 2024Article
- Outcomes after transcarotid artery revascularization stratified by preprocedural symptom status.Journal of vascular surgery · 2022Article
- Association of carotid revascularization approach with perioperative outcomes based on symptom status and degree of stenosis among octogenarians.Journal of vascular surgery · 2022Article
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8 authors at 4 institutions in 3 countries.
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Abstract
objectiveThe available data on outcomes after transfemoral carotid artery stenting (TFCAS) originate from the early experience with TFCAS. Although most previous studies stratified outcomes according to a symptomatic or asymptomatic presentation, they often did not specify the degree of presenting neurologic injury. We previously reported that the outcomes after carotid endarterectomy differed according to neurologic injury severity, the contemporary perioperative outcomes of TFCAS stratified by the specific presenting symptom status are unknown.
methodsPatients with data in the Vascular Quality Initiative database who had undergone TFCAS from 2016 to 2020 were included. We stratified patients according to their preprocedural symptom status as asymptomatic, formerly symptomatic (last symptoms >180 days before the procedure), or recently symptomatic (symptoms <180 days before the procedure). The symptoms included stroke, hemispheric transient ischemic attack (TIA), and ocular TIA. We compared the occurrence of in-hospital stroke or death (stroke/death) among the asymptomatic, formerly symptomatic, and specific subtypes of recently symptomatic patients. Multivariable logistic regression models were constructed to adjust for the baseline differences among the groups.
resultsOf the 9807 included patients, 2650 (27%) had had recent stroke, 842 (9%), recent hemispheric TIA, and 360 (4%), recent ocular TIA. In addition, 795 patients (8%) were formerly symptomatic and 5160 (53%) were asymptomatic. The patients with recent stroke had a perioperative stroke/death rate of 5.5%, higher than that of patients with recent hemispheric TIA (2.4%; P < .001) or recent ocular TIA (2.8%; P = .03) and asymptomatic patients (1.4%; P < .001). The stroke/death rate was greater for patients with recent ocular TIA than for asymptomatic patients (2.8% vs 1.4%; P = .04). Formerly symptomatic patients had higher stroke/death rates compared with asymptomatic patients (3.5% vs 1.4%; P < .001). On multivariable-adjusted analysis, recent stroke was associated with higher stroke/death compared with recent hemispheric TIA (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.6-4.3; P < .001) and asymptomatic status (OR, 4.1; 95% CI, 3.0-5.6; P < .001) and demonstrated a trend toward higher stroke/death compared with recent ocular TIA (OR, 2.0; 95% CI, 1.0-3.9; P = .06). Furthermore, asymptomatic status was associated with lower stroke/death compared with formerly symptomatic status (OR, 0.4; 95% CI, 0.2-0.6; P < .001).
conclusionsFor patients undergoing TFCAS, recent stroke was associated with greater odds of in-hospital stroke/death after TFCAS compared with recent hemispheric TIA. Also, formerly symptomatic status was associated with greater odds of stroke/death compared with asymptomatic status. These findings support further symptom stratification by the degree of the presenting neurologic injury in the preoperative risk assessment.
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