NCDR Study Shows Presence of CCO Not Associated With Adverse Neurological Events

A study published on Jan. 21 in JACC Cardiovascular Interventions found that in patients undergoing elective carotid artery stenting (CAS) the presence of a contralateral carotid artery occlusion (CCO) was not associated with an increased risk of in-hospital death, nonfatal myocardial infarction (MI) or nonfatal stroke.

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Using data from the NCDR®'s CARE Registry®, the study looked at 13,993 patients who underwent elective CAS, of which 1,450 (10 percent) had a CCO. Within the 5,500 CAS procedures, 1,375 were CCO and 4,125 were non-CCO. The primary composite endpoint of in-hospital death, nonfatal MI and nonfatal stroke, occurred in 29 (2.1 percent) and 107 (2.6 percent) patients with and without CCO, respectively (adjusted odds ratio: 0.81, 95 percent CI: 0.53 to 1.23, p = 0.316).

The authors note that CCOs are associated with adverse neurological events following carotid endarterectomy, but were not found to be associated with higher complications following CAS in older patients or individual patients with prior neurological symptoms. They conclude that these findings "may have implications on the selection of carotid revascularization procedures for such patients."

"Observational analyses from the NCDR's CARE Registry such as this present study increasingly offer valuable insight for both clinicians and their patients in the assessment of treatment strategy options available for the management of cerebrovascular disease," said Ralph Brindis, MD, MPH, MACC, senior medical officer of External Affairs - ACC-NCDR, and a co-author of the study.

Clinical Topics: Invasive Cardiovascular Angiography and Intervention, Vascular Medicine, Interventions and Vascular Medicine

Keywords: Registries, Myocardial Infarction, Stroke, Cerebrovascular Disorders, Endarterectomy, Carotid, Carotid Arteries, Stents

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