Abstract Details

Title National Estimates Of Recurrent Ischemic Stroke Among Patients Undergoing Carotid Revascularization: Effect Of Treatment Modality

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P15 - Poster Session 15 (12:00 PM-1:00 PM)

Poster/Presentation
Number 4-013

Objective To determine the rates of ischemic stroke-related hospitalization within 3 months post-hospitalization for treatment of carotid stenosis in a nationwide cohort

Background The estimates of recurrent ischemic stroke in the post-hospitalization period among patients treated for carotid revascularization are not available outside clinical trials (real-world settings).

Design/Methods We identified all readmissions related to new ischemic stroke in the nationally representative data for all patients hospitalized for carotid revascularization using the Nationwide Readmissions Database (NRD) 2013 and 2014 for carotid stent placement (CAS) and carotid endarterectomy (CEA). Cox proportional hazards analysis was used to assess the relative risk (RR) of recurrent ischemic stroke for patients in treatment cohorts after adjusting for potential confounders. The survival was estimated for both treatment groups by using Kaplan-Meier survival method.

Results A total of 120, 923patients with carotid stenosis were treated with either CAS (n = 15, 819; 13.1%) or CEA (n = 105,103; 86.9%).- The estimated 3 month recurrent ischemic stroke free survival was 99.2% and 98.9% in patients who underwent CEA and CAS treatments, respectively (p= 0.014). After adjusting for age, and APDRG severity score, the RRs of recurrent any ischemic stroke was higher in those treated wiht CAS (RR, 1.2; 95% confidence interval (CI), 0.8 -1.6), women (RR, 1.3; 95% (CI), 1.1 -1.6), symptomatic patients (RR, 1.5; 95% (CI), 1.1 -2.1) and weekend admission RR, 1.6; 95% (CI), 1.1 -2.3).

Conclusions Although the rates of recurrent ischemic stroke-related hospitalization were low among patients undergoing carotid revascularization, there was a higher rate among symptomatic patients and those treated with CAS in real-world settings.

Authors/Disclosures
Sairah Bashir, MD, F�鶹��ýӳ�� PRESENTER	Dr. Bashir has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic .
Saqib A. Chaudhry, MD	Dr. Chaudhry has nothing to disclose.
Yun Fang	No disclosure on file
	No disclosure on file
Ameer Hassan, DO (Valley Baptist Medical Center)	Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medtronic. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Stryker. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Penumbra. Dr. Hassan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Cerenovus. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Viz.ai. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Hassan has received research support from GE Healthcare.
	No disclosure on file
	No disclosure on file
Muhammad F. Suri, MD (St Cloud Hospital)	Dr. Suri has nothing to disclose.
Farhan Siddiq, MD	Dr. Siddiq has nothing to disclose.
Camilo R. Gomez, MD, F�鶹��ýӳ�� (University of Missouri)	Dr. Gomez has nothing to disclose.
Hamza I. Maqsood, MD (Dept of Neurology)	Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.

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