Diabetes Does not Affect Outcome of Symptomatic Carotid Stenosis Treated with Endovascular Techniques

Abstract

Background: The influence of diabetes on carotid revascularization techniques is controversial, with few data regarding angioplasty and stenting (CAS). Our purpose was to analyze whether its presence constitutes a risk factor for poor outcome of patients with carotid stenosis treated with CAS. Methods: We compared 30-day and long term morbidity and mortality, as well as restenosis rates, of non diabetic and diabetic patients with symptomatic carotid stenosis treated with endovascular techniques. Results: 318 consecutive patients, 116 (36.5%) of them diabetics, were followed for a median of 56 months. Cumulative 30-day stroke, ischemic cardiopathy and death rate was 4% for non diabetics and 5.2% for diabetics (non significant). Long term stroke and mortality rate was 26.4% for the first group and 34.3% for the second (non significant). The most frequent causes of death were myocardial infarction (17.5% non diabetics, 44% diabetics, p = 0.04), ischemic stroke (12.5% non diabetics, 4% diabetics, non significant) and cancer (30% non diabetics, 16% diabetics, non significant). Twelve patients (6.4%) had restenosis ≥50%, 5.9% non diabetic, 7.4% diabetic, also without statistical significance. Conclusions: In our series, endovascular treatment is both efficient and safe in diabetic patients with symptomatic carotid stenosis; therefore, the presence of diabetes mellitus did not increase the risks linked to CAS procedure.

Impact of Diabetes Mellitus on Early Clinical Outcome and Stent Restenosis after Carotid Artery Stenting

“…Yet, according to our study, at one year follow-up, the rate of major cerebrovascular events is leveling, with similar outcomes between the two groups. Our findings are consistent with the conclusion of other previously published data [17][18][19][20]. Moreover, our early <30 days overall stroke/death rates fell under the 3% threshold in elective cases recommended by the American and European societies [12,21].…”

Impact of diabetes on carotid artery revascularization

“…Study characteristics are summarized in Table I. [9][10][11][12][13][14][15][16][17][18][19][20][21][22] All 14 finally selected studies were observational cohort studies published in English, with the majority (93%) being retrospective in design. Nine (64%) studies were from Europe, four (29%) from the United States, and one (7%) from Japan.…”