Progression of carotid near-occlusion to complete occlusion: related factors and clinical implications
Por:
Garcia-Pastor, A, Gil-Nunez, A, Ramirez-Moreno, JM, Gonzalez-Nafria, N, Tejada, J, Moniche, F, Portilla-Cuenca, JC, Martinez-Sanchez, P, Fuentes, B, Gamero-Garcia, MA, de Lecinana, MA, Masjuan, J, Canovas, D, Aladro, Y, Parkhutik, V, Lago, A, De Arce, AM, Usero-Ruiz, M, Delgado-Mederos, R, Pampliega, A, Ximenez-Carrillo, A, Bartulos-Iglesias, M, Castro-Reyes, E
Publicada:
1 dic 2020
Resumen:
Background
The clinical consequences and factors related to the progression from a carotid near-occlusion (CNO) to a complete occlusion are not well established. Our aim is to describe the rate, predictive factors and clinical implications of the progression to complete carotid occlusion (PCCO) in a population of patients with symptomatic CNO.
Methods
We conducted a multicenter, nationwide, prospective study from January 2010 to May 2016. Patients with angiography-confirmed CNO were included. We collected information on demographic data, clinical manifestations, radiological and hemodynamic findings, and treatment modalities. A 24 month carotid-imaging follow-up of the CNO was performed.
Results
141 patients were included in the study, and carotid-imaging follow-up was performed in 122 patients. PCCO occurred in 40 patients (32.8%), and was more frequent in medically-treated patients (34 out of 61; 55.7%) compared with patients treated with revascularization (6 out of 61; 9.8%) (p<0.001). 7 of the 40 patients with PCCO (17.5%) suffered ipsilateral symptoms. Factors independently related with PCCO in the multivariate analysis were: age >= 75 years (OR 2.93, 95% CI 1.05 to 8.13), revascularization (OR 0.07, 95% CI 0.02 to 0.20), and collateral circulation through the ipsilateral ophthalmic artery (OR 3.25, 95% CI 1.01 to 10.48).
Conclusions
PCCO occurred within 24 months in more than half of the patients under medical treatment. Most episodes of PCCO were not associated with ipsilateral symptoms. Revascularization reduces the risk of PCCO.
Filiaciones:
Garcia-Pastor, A:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Gil-Nunez, A:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Ramirez-Moreno, JM:
Hosp Univ Infanta Cristina, Badajoz, Spain
Gonzalez-Nafria, N:
Complejo Asistencial Univ Leon, Leon, Spain
Tejada, J:
Complejo Asistencial Univ Leon, Leon, Spain
Moniche, F:
Hosp Univ Virgen Rocio, Seville, Spain
Portilla-Cuenca, JC:
Hosp San Pedro Alcantara, Caceres, Spain
Martinez-Sanchez, P:
Hosp Univ La Paz, Madrid, Spain
Fuentes, B:
Hosp Univ La Paz, Madrid, Spain
Gamero-Garcia, MA:
Hosp Univ Virgen Macarena, Seville, Spain
de Lecinana, MA:
Hosp Univ Ramon y Cajal, Madrid, Spain
Masjuan, J:
Hosp Univ Ramon y Cajal, Madrid, Spain
Canovas, D:
Hosp Parc Tauli, Sabadell, Spain
Aladro, Y:
Hosp Univ Getafe, Getafe, Spain
Parkhutik, V:
Hosp Univ & Politecn La Fe, Valencia, Spain
Lago, A:
Hosp Univ & Politecn La Fe, Valencia, Spain
De Arce, AM:
Hosp Univ Donostia, San Sebastian, Spain
Usero-Ruiz, M:
Hosp Clin Univ Valladolid, Valladolid, Spain
Delgado-Mederos, R:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Pampliega, A:
Hosp Gen Univ Alacant, Alicante, Spain
Ximenez-Carrillo, A:
Hosp Univ La Princesa, Madrid, Spain
Bartulos-Iglesias, M:
Complejo Asistencial Univ Burgos, Burgos, Spain
Castro-Reyes, E:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
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