Carotid stenting: risk factors for periprocedural stroke

Abstract

Carotid artery stenting is rapidly emerging as a minimally invasive alternative to carotid endarterectomy for the treatment of cervical carotid artery occlusive disease and stroke prevention. Periprocedural stroke risk still remains a concern despite improvements in technique and equipment. We will review technical, clinical and radiographic factors associated with an increased risk of stroke during carotid artery stenting. The primary focus will be on technical proficiency of the interventionalist, patient comorbid conditions (i.e., diabetes, coronary artery disease, renal failure and advanced age) and equipment (i.e., embolic protection systems and stent designs) that have been identified in the literature as predictors of poorer outcomes.

Keywords::

• carotid artery stenting
• chronic kidney disease
• closed-cell stents
• coronary artery disease
• diabetes mellitus
• diffusion weighted MRI
• embolic protection devices
• octogenarians
• open-cell stents
• technical proficiency

Financial & competing interests disclosure

Mark K Eskandari serves as a consultant for Cook, Cordis, Abbott Vascular Devices, Medtronic, Boston Scientific, Terumo and W.L Gore & Associates, Inc. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.