Diabetes Mellitus as a Risk Factor for Early Outcome After Carotid Endarterectomy – a Population-based Studyf1

Ahari, Abdi; Bergqvist, David; Troëng, Thomas; Elfström, Johan; Hedberg, B; Ljungström, Karl-Gösta; Norgren, Lars; Örtenwall, Per

doi:10.1053/ejvs.1999.0852

Cited by 45 publications

(24 citation statements)

References 4 publications

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“…Several studies have shown that patients with diabetes present higher incidence of death and cardiovascular complications when undergoing endarterectomy [13,15]. Diabetes has been described by multiple authors [3,13,16,17,18] as a factor significantly affecting the results of CEA, but others have reported conflicting results [19,20,21,22]. …”

Section: Discussionmentioning

confidence: 99%

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

Lago

Parkhutik²,

Tembl³

et al. 2013

Eur Neurol

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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.

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Section: Discussionmentioning

confidence: 99%

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

Lago

Parkhutik²,

Tembl³

et al. 2013

Eur Neurol

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“…4 On the contrary, in another study, patients with diabetes had higher cardiac-related mortality, but there was no significant difference between the two groups of patients in neurologic postoperative morbidity. 3 Few studies have analysed the influence of DM on outcomes among patients who underwent CAS. A pooled analysis of outcomes from 2196 procedures found no higher perioperative risk of major adverse cardiac events in patients with diabetes who underwent CAS procedure.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 In addition, stroke in patients with diabetes is associated with a worse functional outcome and higher mortality compared to their counterparts. 3 There is conflicting evidence on the effect of DM on the outcomes of patients undergoing carotid endarterectomy (CEA). A number of studies reported increased perioperative risk of stroke and death in patients with diabetes undergoing surgery, 4,5 and in some series, it was a marker of coronary insufficiency and a predictor of cardiac adverse events.…”

Section: Introductionmentioning

confidence: 99%

Is diabetes a marker of higher risk after carotid revascularization? Experience from a single centre

Casana

Malloggi

Odero

et al. 2018

Diabetes and Vascular Disease Research

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Purpose: This single centre study investigates the influence of diabetes mellitus on outcomes following carotid artery endarterectomy or stenting. Methods: In total, 752 carotid revascularizations (58.2% carotid artery stenting and 41.8% carotid endarterectomy) were performed in 221 (29.4%) patients with diabetes and 532 (70.6%) patients without diabetes. The study outcomes were death, disabling and non-disabling stroke, transient ischaemic attack and restenosis within 36 months after the procedure. Results: Patients with diabetes had higher periprocedural risk of any stroke or death (3.6% diabetes vs 0.6% no diabetes; p < 0.05), transient ischaemic attack (1.8% diabetes vs 0.2% no diabetes; p > 0.05) and restenosis (2.7% diabetes vs 0.6% no diabetes; p < 0.05). During long-term follow-up, there were no significant differences in Kaplan-Meier estimates of freedom from death, any stroke and transient ischaemic attack, between people with and without diabetes for each carotid artery stenting and carotid endarterectomy subgroup. Patients with diabetes showed higher rates of restenosis during follow-up than patients without diabetes (36-months estimate risk of restenosis: 21.2% diabetes vs 12.5% no diabetes; p < 0.05). Conclusion:The presence of diabetes was associated with increased periprocedural risk, but no further additional risk emerged during longer term follow-up. Restenosis rates were higher among patients with diabetes.

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“…4. A case -control study nested in the cohort of a national registry is an appropriate method to study complications and other adverse events after vascular surgery [26].…”

Section: The Utility Of a Vascular Registrymentioning

confidence: 99%

“…In-depth analysis of specific patient groups. We have validated the registry for femoropopliteal reconstructions [14], adverse events after chronic leg ischaemia [17,20], amputations [21,25], complications after carotid surgery [26,27], colonic ischaemia after aortoiliac surgery [22,23], mesenteric revascularisation [28] and reoperations in general [24]. Triangular inspections where hospital A inspects hospital B which inspects hospital C which inspects hospital A.…”

Section: B1 How Do We Address Validity?mentioning

confidence: 99%

National vascular registries

Troëng¹,

Björck

2004

International Congress Series

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Diabetes Mellitus as a Risk Factor for Early Outcome After Carotid Endarterectomy – a Population-based Studyf1

Abstract: diabetics had both a higher 30-day and 1-year mortality after CEA compared to non-diabetics, mainly because of cardiac complications. However, postoperative neurologic morbidity did not differ.

Cited by 45 publications

References 4 publications

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

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

Is diabetes a marker of higher risk after carotid revascularization? Experience from a single centre

National vascular registries

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