Objectives: The goal of this study was to determine the frequency and to identify potential
clinical risk factors for the development of medical complications after carotid angioplasty
and stenting (CAS).
Background: CAS is being evaluated as an alternative to carotid endarterectomy for the treatment
of carotid artery stenosis, however, to date little is known about the incidence of
medical complications after CAS.
Methods: Medical complications that occurred within 30 days after CAS in 327 consecutive
patients (241 men, 86 women; mean age 69 „b 9 years, range 45–90 years) treated for
symptomatic (n=182; 56%) or asymptomatic (n=145; 44%) carotid artery stenosis were
recorded. The effect of clinical characteristics on the subsequent development of
medical complications was analyzed by logistic regression.
Results: Fifty-one patients (15%) had 62 medical complications: 3 (0.9%) myocardial infarctions,
3 (0.9%) cardiac arrhythmias, 4 (1.2%) episodes of angina pectoris, 3 (0.9%) episodes
of symptomatic hypertension, 16 (4.9%) episodes of symptomatic hypotension, 10 (3.1%)
chest infections, 9 (2.7%) periods of confusion, 5 (1.5%) urinary retention and 9
(2.7%) urinary tract infections. Of the 62 medical complications one chest infection
was fatal and 16 prolonged the intensive care unit monitoring period beyond 24 hours.
Advanced age (OR, 1.1; 95% CI, 1.05 to 1.14) and the presence of a symptomatic carotid
stenosis (OR, 2.1 95% CI, 1.07 to 4.1) independently predicted the occurrence of medical
complications.
Conclusions: Although life-threatening or fatal nonneurological events were uncommon in this
series, the overall incidence of medical complications after CAS might be higher than
previously thought. Older and symptomatic patients are at highest risk so that these
subgroups should be monitoring closely.
