Lots of interesting abstracts and cases were submitted for TCTAP 2024. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP A-041
Long Term Effect of Treatment in Patients With Carotid Angioplasty and Stenting In-Stent Restenosis
By Sheng-Fu Liu, Ying-Hsien Chen, Mao-Shin Lin, Ching-Chang Huang, Chih-Fan Yeh, Cheng-Hsuan Tsai, Hsien-Li Kao
Presenter
Sheng-Fu Liu
Authors
Sheng-Fu Liu1, Ying-Hsien Chen2, Mao-Shin Lin2, Ching-Chang Huang2, Chih-Fan Yeh2, Cheng-Hsuan Tsai2, Hsien-Li Kao2
Affiliation
National Taiwan University Hospital Hsin-Chu Branch, Taiwan1, National Taiwan University Hospital, Taiwan2
View Study Report
TCTAP A-041
Carotid Intervention
Long Term Effect of Treatment in Patients With Carotid Angioplasty and Stenting In-Stent Restenosis
Sheng-Fu Liu1, Ying-Hsien Chen2, Mao-Shin Lin2, Ching-Chang Huang2, Chih-Fan Yeh2, Cheng-Hsuan Tsai2, Hsien-Li Kao2
National Taiwan University Hospital Hsin-Chu Branch, Taiwan1, National Taiwan University Hospital, Taiwan2
Background
Carotid angioplasty and stenting (CAS) is one of the mainstream treatments for extracranial carotid artery stenoses. Carotid angioplasty and stenting in-stent restenosis (CAS ISR) is associated with an increased rate of recurrent cerebrovascular events. The treatment strategy for patients with restenosis after carotid angioplasty and stent placement is rather ambiguous, and whether patients will receive clinical benefit after treatment is also questionable. The purpose of this study is to investigate the long-term prognosis of patients with carotid angioplasty with stenting restenosis after endovascular intervention.
Methods
We conducted a retrospective cohort study of consecutive CAS from 1997 to 2021 and enrolled subjects with CAS ISR ≥50% who were divided into two groups according to whether the patients received endovascular intervention or not. We analyzed baseline demographic data, and angiographic and procedural characteristics. The primary endpoint was the composite of all-cause mortality, ipsilateral stroke, and myocardial infarction. Cox proportional hazards regression models were used to estimate the incidence of the primary endpoint in different groups.
Results
A total of 106 patients with CAS ISR ≥50% were enrolled, where 63 (59.4%) subjects received endovascular intervention and 43 (40.6%) subjects were not. Median follow-up for the cohort was 1,044 days (330-1,847). There were significant differences between the arms with sex (p = 0.045), degree of ISR (p < 0.05), ipsilateral CCAS (p = 0.038), total occlusion (p = 0.024) and multiple stents (p = 0.010). In Cox regression analysis, there were no statistically difference among the endovascular intervention and nonintervention groups for the composite of all-cause mortality, ipsilateral stroke, and myocardial infarction. By Kaplan-Meier analysis, there were no statistically difference between the both groups with respect to death / stroke / MI as a composite at last follow-up (p = 0.5).
Conclusion
For the patients with CAS ISR ≥50%, there were no significant difference between endovascular intervention and nonintervention groups in long term outcomes. Endovascular intervention failed to improve long term death / stroke / MI relative to nonintervention in current study.