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Intracranial hemorrhage after carotid angioplasty: a pooled analysis

Cited 16 time in Web of Science Cited 18 time in Scopus
Authors
Kang, Hyun-Seung; Han, Moon Hee; Kwon, O-Ki; Kwon, Bae Ju; Kim, Sung Hyun; Oh, Chang Wan
Issue Date
2007-02-13
Publisher
International Society of Endovascular Specialists
Citation
J Endovasc Ther. 2007 Feb;14(1):77-85.
Keywords
AdultAgedAged, 80 and overAngioplasty/*adverse effectsCarotid Artery Diseases/pathology/physiopathology/*surgeryFemaleHumansIncidenceIntracranial Hemorrhages/epidemiology/*etiologyMaleMiddle AgedRisk Factors*StentsTreatment Outcome
Abstract
PURPOSE: To use a pooled analysis of the literature to find the incidence of and characteristics common to intracranial hemorrhage (ICH) associated with carotid artery stenting (CAS). METHODS: A search of the English-language literature (1996-2005) was performed in PubMed to find cases of CAS-associated ICH. Information was derived from the identified case studies in 5 categories and 19 aspects: (1) incidence of CAS-associated ICH; (2) demographic data (sex, age, symptom presentation, and presence of preexisting hypertension); (3) imaging data (side of lesion, degree of maximal stenosis, lesion location, status of the contralateral carotid artery, collateral circulation, and preprocedural imaging features); 4) procedure-related characteristics (antithrombotic medication, use of cerebral protection devices, residual stenosis, symptoms, interval from the procedure to ICH, type of ICH, and blood pressure changes); and (5) clinical outcome. RESULTS: Fifty-four cases of CAS-associated ICH were reviewed: 51 cases from 36 published articles and our own 3 cases. The incidence of CAS-associated ICH was 0.63% (95% CI 0.38% to 0.97%) in studies consisting of >100 cases, which was significantly lower (p<0.0001) than that of case series consisting of <100 cases (2.69%, 95% CI 1.75% to 3.94%). Distinctive features included symptomatic lesions, severe stenosis (> or =90%), maximal stenosis in the internal carotid artery (ICA) distal to the bifurcation, and preexisting cerebral infarction. CONCLUSION: The incidence of CAS-associated ICH was significantly lower in series consisting of >100 cases. More caution should be directed toward patients with symptomatic lesions, severe stenosis, maximal ICA stenosis distal to the carotid bifurcation, and preexisting cerebral infarction.
ISSN
1526-6028 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17291153

http://hdl.handle.net/10371/16133
DOI
https://doi.org/10.1583/06-1991.1
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College of Medicine/School of Medicine (의과대학/대학원)Neurosurgery (신경외과학전공)Journal Papers (저널논문_신경외과학전공)
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