The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques · 2025
Trigeminal Neuralgia Associated with a Solitary Pontine Lesion.
СтатьяНазвание и аннотация: Перевод в очереди
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Sim Holly, Steiner Kyra, Dewar Brian, Fahed Robert, Roberts Derek J, Gocan Sophia, Singh Nishita, Chakraborty Santanu, Portela de Oliveira Eduardo, Dowlatshahi Dar, Shamy Michel
Аннотация
BACKGROUND AND OBJECTIVES: Although carotid endarterectomy (CEA) or carotid artery stenting (CAS) is recommended for symptomatic extracranial carotid stenosis of 50-99%, the COVID-19 pandemic significantly impacted resources. CAS therefore offered potential advantages as access to the angiosuite was seemingly easier than access to operating rooms. The primary objective was to determine the frequency of serious and non-serious complications following CAS before and during the COVID-19 pandemic.
METHODS: We performed a retrospective cohort study of consecutive patients who received CAS at the Ottawa Hospital, Canada, from June 2019 to May 2021. We reviewed baseline demographics, imaging, as well as intraprocedural and postprocedural complications based on chart review. We performed multivariable logistic regression to determine associations between clinical and safety outcomes.
RESULTS: We included 47 patients in the pre-pandemic period and 93 patients in the pandemic period (mean age = 70.4 years; 54% female; P = 0.287 for age and P = 0.962 for sex, respectively). The combined rate of intraprocedural and postprocedural serious complications (ischemic stroke, intracerebral hemorrhage, myocardial infarction or death) was 7.1%. Eight strokes occurred, and one patient with a postprocedural ischemic stroke died 11 days after stenting. Complication rates were similar before and during the pandemic (aOR 1.040, 95% CI 0.466-2.321). The number of referrals for CEA during the pandemic period decreased by 50%.
CONCLUSION: In this cohort of consecutive patients undergoing CAS at a Canadian comprehensive stroke center before and during the COVID-19 pandemic, the rates of stroke and death were similar to pre-pandemic conditions and were generally consistent with the published literature.
METHODS: We performed a retrospective cohort study of consecutive patients who received CAS at the Ottawa Hospital, Canada, from June 2019 to May 2021. We reviewed baseline demographics, imaging, as well as intraprocedural and postprocedural complications based on chart review. We performed multivariable logistic regression to determine associations between clinical and safety outcomes.
RESULTS: We included 47 patients in the pre-pandemic period and 93 patients in the pandemic period (mean age = 70.4 years; 54% female; P = 0.287 for age and P = 0.962 for sex, respectively). The combined rate of intraprocedural and postprocedural serious complications (ischemic stroke, intracerebral hemorrhage, myocardial infarction or death) was 7.1%. Eight strokes occurred, and one patient with a postprocedural ischemic stroke died 11 days after stenting. Complication rates were similar before and during the pandemic (aOR 1.040, 95% CI 0.466-2.321). The number of referrals for CEA during the pandemic period decreased by 50%.
CONCLUSION: In this cohort of consecutive patients undergoing CAS at a Canadian comprehensive stroke center before and during the COVID-19 pandemic, the rates of stroke and death were similar to pre-pandemic conditions and were generally consistent with the published literature.