Acute-phase response after stent implantation in the carotid artery: association with 6-month in-stent restenosis.

Abstract

PURPOSE:

To determine the prognostic importance of periintervention serum levels of acute-phase reactants in 6-month restenosis after stent implantation in the carotid artery.

MATERIALS AND METHODS:

One hundred eight consecutive patients with 70% or greater stenosis of the internal carotid artery (ICA) according to the North American Symptomatic Carotid Endarterectomy Trial criteria underwent successful stent implantation in the ICA in a prospective cohort study. Six-month patency was evaluated at color-coded duplex ultrasonography. The association between in-stent restenosis (> or =50%, North American Symptomatic Carotid Endarterectomy Trial criterion) and C-reactive protein (CRP) and serum amyloid A levels at baseline and at 24 and 48 hours after intervention was assessed.

RESULTS:

Restenosis was found in 15 (14%) patients within 6 months. CRP level at 48 hours, exemplary for the postintervention acute-phase response, was significantly (P =.01) associated with 6-month restenosis by using multiple logistic regression analysis. Recurrent stenosis after prior stent implantation in the carotid artery (odds ratio, 9.2; 95% CI: 1.6, 53.2; P =.01) and residual stenosis of 10%-30% after stent implantation (odds ratio, 9.7; 95% CI: 1.6, 59.3; P =.01) were independent clinical predictors of restenosis.

CONCLUSION:

Extent of vascular inflammatory response after stent implantation in the carotid artery measured with acute-phase reactants is associated with 6-month patency. Recurrent stenosis after prior stent implantation and initial suboptimal technical result seem to be clinically relevant predictors of postangioplasty outcome.

• Authors: Martin Schillinger, Markus Exner, Wolfgang Mlekusch, Helmut Rumpold, Ramazanali Ahmadi, Schila Sabeti, Wilfried Lang, Oswald Wagner, Erich Minar
• Journal: Radiology (Radiology) Vol. 227 Issue 2 Pg. 516-21 (May 2003) ISSN: 0033-8419 [Print] United States
• PMID: 12649420 (Publication Type: Journal Article)
• Copyright: Copyright RSNA, 2003

Chemical References

• Acute-Phase Proteins

Topics

• Acute-Phase Proteins (analysis)
• Acute-Phase Reaction (blood)
• Aged
• Carotid Stenosis (blood, surgery)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Prospective Studies
• Recurrence
• Stents (adverse effects)
• Time Factors