ArticleCardiovascular and interventional radiology2026
The Influence of Arterial Anatomy on Early and Late Outcomes of Carotid Artery Stenting.
Article in Cardiovascular and interventional radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo identify anatomical risk factors for poor perioperative outcomes in patients treated with carotid artery stenting (CAS). To compare long-term results for patients with favourable and hostile anatomy (HA) for CAS. MATERIAL AND
methodsSingle-centre, retrospective study of patients who underwent CAS from 2004 to 2024 at a public hospital in Latin America. Anatomical data were extracted from preoperative imaging regarding the aorta, the supra-aortic trunks, and the internal carotid arteries (ICA). Short-term outcomes included the primary composite outcome of major stroke and death (S/D); any ischaemic neurological event (AINE); major stroke, any stroke. Multivariate analysis (MA) was performed to identify classifying anatomical factors regarding hostility to CAS. Long-term outcomes, defined as AINE; cumulative survival; major stroke-free survival; and stent primary patency (SPP), were analysed using Kaplan-Meier estimates.
resultsMA associated hostile anatomy with complex ICA, defined as either significant tortuosity or near-occlusion. One hundred and eighty-seven CAS procedures were performed in 172 patients, of which 79 (42.3%) had HA. HA correlated with a higher perioperative incidence of AINE (p = .018), any stroke (p = .029), and S/D (p = .049), but not with major stroke (p = .054). At 5 years, the HA group presented higher cumulative incidence of AINE (p = 0,047) and lower SPP (p = 0,011). There were no differences between groups for cumulative survival and major stroke-free survival.
conclusionThe presence of a significantly tortuous or near-occluded ICA correlated with higher incidence of AINE and S/D in patients submitted to CAS. HA for CAS correlated with higher cumulative incidence of AINE and lower SPP rates during follow-up.
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