The impact of diabetes mellitus on carotid artery stenting: a meta-analysis

Chu, Shan-shan; Hu, Jia; Tang, Lingwen; Zhang, Daobao

doi:10.1007/s10143-021-01499-0

Cited by 2 publications

(2 citation statements)

References 22 publications

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“…Previous studies revealed the impact of DM on the adverse outcomes of carotid revascularization, yet the results were likely to cover the potential bias induced by differences in patient selection and intervention between CAS and CEA procedures. [4,5] The current study found that DM predicted increased short-term and long-term MAEs in patients with carotid stenosis undergoing CEA. To our knowledge, this is the most updated and complete systematic review in this regard.…”

Section: Discussionmentioning

confidence: 55%

“…[ 4 ] However, another recent meta-analysis reported that DM failed to predict adverse outcomes in patients after CAS. [ 5 ] The inconsistency of the synthetic results indicated that DM may have a different impact on the outcomes of patients with carotid stenosis treated by CEA, and few conclusive studies with pooled analysis in this regard have been reported. We thus designed and conducted this study to elucidate the impact of DM on the short-term and long-term adverse outcomes of carotid artery stenosis patients after CEA as well as the rates of adverse outcomes after CEA.…”

Section: Introductionmentioning

confidence: 99%

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Diabetes mellitus and adverse outcomes after carotid endarterectomy: A systematic review and meta-analysis

Zhang

et al. 2023

Chinese Medical Journal

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Background: There is still uncertainty regarding whether diabetes mellitus (DM) can adversely affect patients undergoing carotid endarterectomy (CEA) for carotid stenosis. The aim of the study was to assess the adverse impact of DM on patients with carotid stenosis treated by CEA. Methods: Eligible studies published between 1 January 2000 and 30 March 2023 were selected from the PubMed, EMBASE, Web of Science, CENTRAL, and ClinicalTrials databases. The short-term and long-term outcomes of major adverse events (MAEs), death, stroke, the composite outcomes of death/stroke, and myocardial infarction (MI) were collected to calculate the pooled effect sizes (ESs), 95% confidence intervals (CIs), and prevalence of adverse outcomes. Subgroup analysis by asymptomatic/symptomatic carotid stenosis and insulin/noninsulin-dependent DM was performed. Results: A total of 19 studies (n = 122,003) were included. Regarding the short-term outcomes, DM was associated with increased risks of MAEs (

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Section: Discussionmentioning

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Diabetes mellitus and adverse outcomes after carotid endarterectomy: A systematic review and meta-analysis

Zhang

et al. 2023

Chinese Medical Journal

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Predictive Factors for Stroke and TIA Following Carotid Artery Stenting

et al. 2023

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Purpose: Carotid artery stenting (CAS) is an effective and minimally invasive method for the treatment of extracranial carotid artery stenosis. The aim of the present study was to explore independent risk factors to predict cerebrovascular events following CAS to identify high-risk patients and improve the safety of CAS in this population. Materials and Methods: HISPANIAS is a national prospective multicenter study that included 14 hospitals that collected data from patients who underwent CAS. We analyzed morbidity and mortality within 30 days after CAS, looking for factors that might be associated with cerebrovascular events (stroke and transient ischemic attack [TIA]). Results: The HISPANIAS cohort included 757 patients: 80.32% were men, the mean age was 70.73 years, and 82.96% underwent symptomatic CAS. Cerebrovascular complications occurred in 42 patients (5.6%), including TIA in 24 patients (70.8% ipsilateral; mean 2.79 days after CAS) and stroke in 18 patients (72.2% ipsilateral; mean 6.72 days after CAS). The main independent clinical predictors of stroke/TIA identified by logistic regression were female sex (odds ratio [OR] 2.29, 95% CI 1.15–4.54) and diabetes (OR 3.29, 95% CI 1.71–6.40). Survival analysis showed that diabetic women, compared with the rest of the patients, had a higher number of events concentrated mainly in the first days after the intervention (p=0.003). Conclusion: Cerebrovascular ischemic complications after CAS continue to be a challenge for the management of these patients. Although there are other factors, female sex and the presence of diabetes are emerging as strong risk factors for the development of complications after symptomatic CAS. Clinical Impact Carotid artery stenting (CAS) is an effective and minimally invasive method for the treatment of extracranial carotid artery stenosis. Although CAS has been regarded as a reliable and safety approach, some studies reported that CAS was associated with a higher risk of procedure-related stroke. Cerebrovascular complications after CAS continue to be a main problem and a challenge for the management of these patients. Therefore, it is essential to identify the factors involved in the development of these complications. Our study shows that the combination of female sex and diabetes is associated with a clearly worse outcome, with a greater number of events concentrated mainly in the first days. This is different from other studies that have explored each factor separately. It would be interesting to perform separate interventions for this group given the increased risk of complications.

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The impact of diabetes mellitus on carotid artery stenting: a meta-analysis

Cited by 2 publications

References 22 publications

Diabetes mellitus and adverse outcomes after carotid endarterectomy: A systematic review and meta-analysis

Diabetes mellitus and adverse outcomes after carotid endarterectomy: A systematic review and meta-analysis

Predictive Factors for Stroke and TIA Following Carotid Artery Stenting

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