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Early treatment after a symptomatic event is not associated with an increased risk of stroke in patients undergoing carotid stenting.

Gröschel K, Knauth M, Ernemann U, Pilgram SM, Schnaudigel S, Kastrup A

Department of Neurology, University of Göttingen, Göttingen, Germany. klaus.groeschel@medizin.uni-goettingen.de

A recently symptomatic carotid artery stenosis carries a high risk of subsequent ischaemic events and thus requires rapid treatment. We investigated the influence of the time delay between the last symptomatic event of a carotid stenosis and subsequent carotid artery stenting (CAS) with respect to the combined 30-day outcome of stroke and death. In a group of 320 patients undergoing CAS the median delay before the intervention was 19 days (interquartile range 10-36) and the combined 30-day complication rate was 8.4%. Time delay was not significantly associated with peri-procedural complications, regardless of whether this variable was dichotomized (<14 days and > or =14 days), separated into interquartile ranges or analysed as a continuous variable. Our results indicate that early CAS is not associated with an increased complication rate in patients with a recently symptomatic carotid stenosis. Thus, if CAS has been selected as the treatment modality for a patient, it should be performed as soon as possible to maximize the benefit of the intervention in reducing the risk of stroke.

Published 3 January 2008 in Eur J Neurol, 15(1): 2-5.
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