Background

There is not a widely accepted optimal rate of stent opening in patients underwent carotid artery stenting. In this study we evaluated the effect of carotid stent opening rate (CSOR) without performing post-dilation on in-hospital and long-term outcomes.

Methods

A total of 825 patient patients underwent carotid artery stenting without post-dilation enrolled to the study. The patients divided into two groups according to their final CSOR (50% ≤ Post-stent deployment (SD) <80% and 80% ≤ Post-SD ≤ 100%). In-hospital and 3-year outcomes were compared between the groups.

Results

During hospitalization, the rate of ipsilateral stroke, major stroke and transient ischemic attacks were similar between the groups (respectively; 6.2% vs. 4.1, P = 0.190; 1.5% vs. 1.8, P = 0.811; 1.5% vs. 1.9%, P = 0.683). The 3-year Kaplan-Meier overall survival rates for the first and second groups were 87.6% and 84.4%, respectively (log rank test P = 0.426). The 3-year Kaplan-Meier overall cumulative ipsilateral stroke rates for the first and second groups were 88.0% and 88.6%, respectively (log rank test P = 0.409)

Conclusion

Our study demonstrated that a CSOR higher than 50% without performing a post-dilation might be an effective therapeutic approach since there was not a significant difference regarding outcomes between the patients with a 50% ≤ Post-SD <80% and 80% ≤ Post-SD ≤ 100%. The need for post-stent balloon dilation might have been eliminated due to subsequent stent self-expansion.

中文翻译：

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没有后扩张的最佳颈动脉支架打开率应该是多少？

背景

在接受颈动脉支架置入术的患者中，支架打开的最佳速率尚未得到广泛认可。在这项研究中，我们评估了不进行扩张后颈动脉支架打开率（CSOR）对医院和长期预后的影响。

方法

共有825例患者接受了未经扩张的颈动脉支架置入研究。根据最终CSOR将患者分为两组（50％≤支架后部署（SD）<80％，而80％≤SD后≤100％）。比较两组间的住院和3年结局。

结果

住院期间，两组的同侧中风，大中风和短暂性脑缺血发作的发生率相似（分别为：6.2％vs. 4.1，P = 0.190； 1.5％vs. 1.8，P = 0.811； 1.5％vs. 1.9％， P = 0.683）。第一组和第二组的3年Kaplan-Meier总生存率分别为87.6％和84.4％（对数秩检验P = 0.426）。第一组和第二组的3年Kaplan-Meier总同侧中风发生率分别为88.0％和88.6％（对数秩检验P = 0.409）

结论

我们的研究表明，不进行扩张后CSOR高于50％可能是一种有效的治疗方法，因为50％≤SD后<80％和80％≤Post的患者之间的结局无显着差异-SD≤100％。由于随后的支架自扩张，可能消除了支架后球囊扩张的需要。