|The CAPTURE Registry: Incidence, Timing, Distribution and Severity of Stroke Following Carotid Artery Stenting In Symptomatic and Asymptomatic Patients|
|Ronald M Fairman* |
Hospital University of Pennsylvania, Philadelphia, PA
|OBJECTIVE(S): The purpose of this report is to analyze the incidence (compared to carotid endarterectomy), timing, distribution, and severity of stroke following carotid artery stenting (CAS).|
METHODS: All patients experiencing a primary endpoint were included in the analysis.
RESULTS: 30 day results were available for 3500 patients. The rate of stroke at 30 days was 4.8% (3.9% ipsilateral and 0.9 % non-ipsilateral, 2% major). A majority of strokes (57.7%) happened post-procedure and pre discharge, while 22.3% occurred during the procedure and 20% post discharge.
Overall 41% of all strokes were major. Among the ipsilateral strokes 44% were major, while only 26% of the non-ipsilateral strokes were major.
The incidence of major strokes was statistically significantly different among symptomatic and asymptomatic patients, respectively 4.6% and 1.6%.
There was a tendency (p=0.10) towards more minor than major strokes in asymptomatic patients (63% vs.37%). There was a tendency towards more major hemorrhagic strokes in symptomatic than in asymptomatic patients (36% vs. 17%, p=0.07). 37.8% of the strokes happening post-procedure and pre discharge were major while 55.9% of the strokes happening post discharge were major.
23% of the major strokes were hemorrhagic. 94%, of these strokes occurred on the ipsilateral side. 56% happened post-procedure and pre-discharge, while 31% happened post-discharge.
CONCLUSIONS: Although the incidence of stroke following CAS is similar to carotid endarterectomy, 20% of the strokes following CAS were non-ipsilateral and 40% of all strokes may be related to catheter manipulation dislodging aortic arch atheroma. Most strokes present post-procedure and prior to discharge.
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