London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 847 947 Interventional neurology Frequency of restenosis after carotid artery stenting using an ultrasonographic diagnostic pro-tocol P. Barros1, H. Felgueiras2, D. Pinheiro3, M. Guerra4, V. Gama5, M. Veloso6 Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PORTUGAL1, Centro Hos-pitalar Vila Nova de Gaia, Vila Nova de Gaia, PORTUGAL2, Centro Hospitalar Vila Nova de Gaia, Vila NOva de Gaia, PORTUGAL3, Centro Hospitalar de Vila NOva de Gaia, Vila Nova de Gaia, PORTUGAL4, Centro Hospitalar de Vila NOva de Gaia, VIla NOva de Gaia, PORTUGAL5, Centro Hospitalar Vila NOva de Gaia, Vila NOva de Gaia, PORTUGAL6 BACKGROUND Carotid angioplasty with stenting (CAS) is increasing being done, in recent years, as an alternative to endarterectomy for the treatment of ICA stenosis. It becomes very important to assess its dura-bility, as well as identify possible factors that increase the risk of restenosis. Our goal was to eval-uate the restenosis rate in patients undergoing CAS at our institution over the past 5 years, using a pre-specified ultrasonographic protocol. METHODS Restenosis were assessed by duplex ultrasonography at 6, 12 and yearly thereafter and were defined as a reduction in diameter of the target artery of at least 50%, diagnosed by a peak systolic velocity of at least 2•0 m/s. The cases in which restenosis was detected by duplex ultrasonography underwent carotid angio-CT. The frequency of restenosis was calculated by Kaplan-Meier survival estimates and was compared during a 2-year follow-up period. RESULTS 100 procedures were performed in 96 patients. The mean age was 73.2 years (46-87 years, 80,2% male). Thirty-seven procedures were performed in symptomatic stenosis and 63 in asymptomatic (all in the context of unstable angina patients, before CABG surgery, data partially published). 73 patients were monitored (76% of the carotid); 12 died (12.5%) and 11 were missed to follow-up. The median follow-up was 29.2 months. Restenosis were detected in 6 carotid arteries, all in-stent, > 50 and <90% (5 previously asymptomatic) - estimated frequency of restenosis at 24 months – 6%. One patient with restenosis had a TIA. The carotid angio-CT confirmed all ultrasonographic detect-ed restenosis. DISCUSSION Restenosis and occlusion were infrequent and rates were similar to those previously published in other series, like CREST. We emphasize the diagnostic agreement achieved between ultrasonogra-phy and angio-CT; we have not been able to control 24% of the carotid arteries, which is an import-ant limitation. 948 Interventional neurology Long-term clinical outcomes of stent placement for symptomatic intracranial arterial stenosis in patients with or without diabetes mellitus J.C. Li1, L.L. Zhang2, B.H. Li3, C.Y. Gao4, J.H. Wang5 Department of Neurology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, CHINA1, Department of Neurology, Institute of Surgery Re-search, Daping Hospital, Third Military Medical University, Chongqing, CHINA2, Department of Neurology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, CHINA3, Department of Neurology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, CHINA4, Department of Neurology, Institute of Sur-gery Research, Daping Hospital, Third Military Medical University, Chongqing, CHINA5 Background: Patients with diabetes mellitus (DM) are at high risk for periprocedural neurological complications after intracranial angioplasty and/or stent placement. However, whether long-term outcomes of intracranial stent placement are different in patients with or without DM is unclear. Objective: To compare the long-term clinical results for intracranial stent placement in symptomatic intracranial atherosclerotic stenosis patients with or without DM. Methods: A retrospective analysis of patients receiving intracranial stenting was performed from January 2007 to June 2011. Patients were assigned to DM group (patients with DM) and non-DM group (patients without DM) according to diabetes status. Technical success rate and periprocedural complication rate were retrospectively reviewed. The long-term follow-up end point was composite of any stroke and death within 30 days, any ischemic stroke beyond 30 days, and TIA in the territory of the stented artery at any time. Kaplan-Meier analysis was performed to calculate the cumulative probability of composite outcomes in the two groups. Results: A total of 44 stenoses in 43 patients were retrospectively analyzed. The procedural success rate was 88.4% (38/43). The total periprocedural complication rate was 9.3% (4/43 patients). There was no difference between the DM group and non-DM group (7.7% vs. 10.0%, P>0.05). Clinical follow-up was available in 36 patients. The mean follow-up time was 19 months (1~57 months) in DM group vs. 28 months (1~61 months) in non-DM group. The cumulative probability of the composite outcomes were 16.1% (95% CI: 16.0% ~ 47.4%) at 1 year and 34.7% (95% CI: 29.1% ~ 33.0%) at 2 years for DM group, and 17.3% (95% CI: 15.8% ~ 31.1%) at both 1 year and 2 years for non-DM group (log-rank test, P =0.385). After adjusting for the confounders, the risk of DM vs. Non-DM for composite outcomes remained insignificant (hazard ratio: 3.03, 95% CI: 0.47 ~ 19.77; P = 0.25). Conclusion: Our results suggest that there was no significant difference between patients with DM and without DM in cumulative probability of the composite outcomes, as well as periprocedural complication rate.
Karger_ESC London_2013
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