Diabetes does not affect outcome of symptomatic carotid stenosis treated with endovascular techniques

Eur Neurol. 2013;69(5):263-9. doi: 10.1159/000346000. Epub 2013 Feb 20.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angioplasty / adverse effects*
  • Carotid Stenosis* / complications
  • Carotid Stenosis* / mortality
  • Carotid Stenosis* / surgery
  • Cause of Death
  • Diabetes Mellitus / mortality
  • Diabetes Mellitus / physiopathology*
  • Diabetes Mellitus / surgery
  • Endovascular Procedures / adverse effects*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Myocardial Infarction / etiology
  • Myocardial Infarction / mortality
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Stroke / etiology
  • Stroke / mortality
  • Treatment Outcome