carotid artery revascularization

^[1]^[2]^[3]^[4]

Complications

perioperative subclinical cerebral ischemia occurs commonly, especially during carotid stenting,
- cognitive deficits can result^[1]^[2]
perioperative morbidity & mortality are substantial^[3]
- 30 day mortality = 1.2% & 2.3% for asymptomatic & symptomatic carotid stenosis, respectively
- 30 day mortality among dialysis patients is 5%^[3]
- rate of stroke or death varies from 1%-6% across U.S. regions^[4]
2 year mortality = 28% & 37% for asymptomatic & symptomatic carotid stenosis, respectively^[3]

↑ ^1.0 ^1.1 Tulip HH et al. Cerebral embolization in asymptomatic versus symptomatic patients after carotid stenting. J Vasc Surg 2012 Dec; 56:1579 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23040713
↑ ^2.0 ^2.1 Zhou W et al. Prospective neurocognitive evaluation of patients undergoing carotid interventions. J Vasc Surg 2012 Dec; 56:1571. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22889720
↑ ^3.0 ^3.1 ^3.2 ^3.3 Jalbert JJ et al. Outcomes after carotid artery stenting in Medicare beneficiaries, 2005 to 2009. JAMA Neurol 2015 Mar; 72:276. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25580726
Yuo TH et al. Revascularization of asymptomatic carotid stenosis is not appropriate in patients on dialysis. J Vasc Surg 2015 Mar; 61:670 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25720927
↑ ^4.0 ^4.1 Shean KE et al. Regional variation in patient outcomes in carotid artery disease treatment in the Vascular Quality Initiative. J Vasc Surg 2018 Sep; 68:749. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29571620 https://www.jvascsurg.org/article/S0741-5214(18)30041-7/fulltext