Will your doctor GUARANTEE no adverse events?
I would never do carotid stenting, way too many possible complications.
Stents were never the permanent solution, they do nothing to address the inflammation in your arteries that creates plaque. And why would you want to put inflexible stents in flexible arteries? I still don't understand why you would medically need to stent a carotid artery at all if the Circle of Willis is complete. (Unless the whole point is revenue and profit generation) It would seem to make more sense to just close it up and prevent problems from there. My right carotid artery was closed for 10 years and I cognitively functioned quite well with no episodes of fainting.
Here is why your doctor needs to GUARANTEE NO complications from stenting!
stenting (22 posts to May 2011)
carotid stenting (21 posts to May 2016)
carotid artery stenting (7 posts to November 2021)
Restenosis is a gradual re-narrowing of the stented segment that occurs mostly between 3 to 12 months after stent placement.
So by not solving the inflammation problem you get this! Stents don't solve the underlying problem, why the fuck is your doctor prescribing them? Money?
New Tool Predicts Stroke Outcome with 93% Accuracy, Guiding Better Carotid Surgery Decisions
Researchers have developed a predictive model with a 93% accuracy rate in determining whether urgent carotid-intervention patients will regain functional independence.
This advanced model uses a data-driven approach that combines 4 critical clinical metrics -- stroke severity, frailty risk score, timing of intervention, and the use of thrombolysis -- to create a real-time decision-making tool. By leveraging these variables, physicians can improve patient care by tailoring treatment plans, optimising intervention timing, and ensuring that the most appropriate patients receive these complex procedures.
The findings are published in the Journal of the American College of Surgeons.
“We are entering a new era of stroke care where data-driven insights guide every decision,” said senior author Hernan A. Bazan, MD, chsner Clinic Foundation, New Orleans, Louisiana. “By integrating a real-time frailty risk score into the electronic medical record, presenting stroke severity and other variables, we can proactively identify who will benefit from immediate surgery and who may need ‘pre-habilitating’ before surgery to achieve better outcomes.”
Stroke requires timely intervention, with carotid endarterectomy (CEA) and carotid artery stenting (CAS) increasingly used in select acute carotid-related stroke patients. The researchers aimed to build a model to predict neurologic functional independence (modified Rankin scale [mRS], ≤2) in this high-risk group.
The researchers analysed data from 302 patients who had a stroke and undergoing urgent CEA or CAS between 2015 and 2023 at a tertiary Comprehensive Stroke Center. Predictors included: (1) stroke severity; (2) time to intervention (≤48 hours); (3) thrombolysis use; and (4) frailty risk score. Multiple models were constructed and selected based on the area under the ROC curve (AUC). The primary endpoint was discharge neurological functional independence (mRS ≤2).
Most (78%) patients were discharged functionally independent (mRS ≤2). The combined 30-day rate of stroke, death, and myocardial infarction was 8.3%, and 6.5% for CEA alone and 12.5% for CAS. The model, incorporating thrombolysis, time to intervention, stroke severity (NIHSS), and frailty risk, correctly predicted 93% of functional independence outcomes (area under the curve, 0.808).
“Predicting a patient’s recovery potential with such reliability gives us an unprecedented level of confidence in our treatment decisions,” said Leo Seoane, MD, Ochsner Health. “This innovation ensures that every patient receives the care best suited to their situation, further advancing our commitment to excellence.”
SOURCE: Ochsner Health
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