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- Title:
Use of an embolic protection device during carotid artery stenting is associated with lower periprocedural risk.
- Document type:
- Journal Article
- Author(s):
- Knappich, Christoph; Bohmann, Bianca; Kirchhoff, Felix; Lohe, Vanessa; Naher, Shamsun; Kallmayer, Michael; Eckstein, Hans-Henning; Kuehnl, Andreas
- Abstract:
- OBJECTIVE: To investigate associations between individual embolic protection device (EPD) use and respective center policy with periprocedural outcomes after carotid artery stenting (CAS). METHODS: This analysis is based on the nationwide German statutory quality assurance database and was funded by Germany's Federal Joint Committee Innovation Fund (G-BA Innovationsfonds, 01VSF19016 ISAR-IQ). According to their policy towards EPD use, hospitals were categorized as routine EPD (>90%), selective EPD (10-90%), or sporadic EPD (<10%) centers. Primary study outcome was in-hospital stroke or death. Univariate and multivariate regression analyses were performed. RESULTS: Overall, 19 302 patients who had undergone CAS between 2013 and 2016 were included. The highest in-hospital stroke or death rate was found in sporadic EPD centers, followed by selective and routine EPD centers (3.1% vs 2.9% vs 1.8%; P<0.001). Across the whole cohort, EPD use was associated with a lower in-hospital stroke or death rate (OR=0.60; 95% CI 0.50 to 0.72). In the multivariate regression analysis, EPD use was independently associated with a lower in-hospital stroke rate (aOR=0.66; 95% CI 0.46 to 0.94). Regarding center policy, routine EPD centers showed a significantly lower in-hospital mortality compared with sporadic EPD centers (aOR=0.44; 95% CI 0.22 to 0.88). CONCLUSIONS: In a contemporary real-world cohort with low risk of selection bias, EPD use was associated with a lower in-hospital risk of stroke. A center policy of routine EPD use was associated with lower mortality. These data support routine use of EPD during CAS to enhance patient safety.
- Journal title abbreviation:
- J Neurointerv Surg
- Year:
- 2024
- Fulltext / DOI:
- doi:10.1136/jnis-2024-021722
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/38906691
- Print-ISSN:
- 1759-8478
- TUM Institution:
- Klinik und Poliklinik für Vaskuläre und Endovaskuläre Chirurgie (Prof. Eckstein)
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