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Editor's Choice - E...
Editor's Choice - Effect of More Expedited Carotid Intervention on Recurrent Ischaemic Event Rate: A National Audit
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- Kragsterman, Björn (författare)
- Uppsala universitet,Kärlkirurgi
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- Nordanstig, Annika, 1974 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology,Gothenburg Univ, Sahlgrenska Univ Hosp & Acad, Dept Neurol, Gothenburg, Sweden
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- Lindstrom, D. (författare)
- Karolinska Institutet
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- Strömberg, Sofia (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,Gothenburg Univ, Sahlgrenska Univ Hosp & Acad, Dept Vasc Surg, Gothenburg, Sweden
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- Thuresson, M. (författare)
- Statisticon AB, Uppsala, Sweden;Swedenburg Univ, Gothenburg, Sweden
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- Nordanstig, Joakim (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,Gothenburg Univ, Sahlgrenska Univ Hosp & Acad, Dept Vasc Surg, Gothenburg, Sweden
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(creator_code:org_t)
- Elsevier BV, 2018
- 2018
- Engelska.
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 56:4, s. 467-474
- Relaterad länk:
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http://www.ejves.com...
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Background: The benefit of carotid endarterectomy (CEA) or stenting (CAS) for symptomatic stenosis depends on the timing in relation to the presenting event. As the risk of recurrent events is highest in the early phase, guidelines recommend a short delay. The purpose of this national audit was to study the effects of more expedient carotid intervention on the risk of recurrent ischaemic events. Methods: Data on all CEA and CAS for symptomatic stenosis, including both recurrent ischaemic events during the waiting time to carotid intervention and peri-operative 30 day complication rates, were obtained from the Swedish Vascular Registry between May 2008 and December 2015. The National Prescribed Drug Registry provided data on preventive medication prior to hospitalisation with the presenting event. The primary endpoint was a recurrent cerebral ischaemic event occurring after the presenting event up to 30 days of post-operative follow up. Results: A total of 6814 procedures for symptomatic carotid stenosis were studied. The proportion of recurrent ischaemic events, meaning all secondary events occurring after the presenting event up to 30 days follow up with inclusion of all pre- and post-intervention recurrences was recorded. These recurrent events decreased over time, from 31% in 2008-2009 to 21% in 2014-2015 (p < .01, chi-square test). In parallel, the median waiting time for carotid intervention decreased from 13 (IQR 6-27) to 7 days (IQR 4-12). Baseline demographic variables and comorbidities were similar during the study period. The proportion of pre-operative recurrences were reduced from 25% to 18% (p < .01, chi-square test) while the peri-operative stroke and/or death rate was 3.6%, and improved slightly during the study. Conclusions: A substantial reduction in the secondary ischaemic event rate was observed when the median waiting time for CEA/CAS was reduced, and this was not counterbalanced by any increase in the peri-operative complication rate. (C) 2018 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- Carotid artery stenosis
- Carotid endarterectomy
- Carotid artery stenting
- Stroke
- Transient ischaemic attack
- increased procedural risk
- acute minor stroke
- swedvasc registry
- artery
- stenosis
- endarterectomy
- surgery
- attack
- delay
- time
- clopidogrel
- Surgery
- Cardiovascular System & Cardiology
- Carotid artery stenosis
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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