Risk of Stroke or Death Is Associated With the Timing of Carotid Artery Stenting for Symptomatic Carotid Stenosis: A Secondary Data Analysis of the German.

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Risk of Stroke or Death Is Associated With the Timing of Carotid Artery Stenting for Symptomatic Carotid Stenosis: A Secondary Data Analysis of the German Statutory Quality Assurance Database by Pavlos Tsantilas, Andreas Kuehnl, Michael Kallmayer, Christoph Knappich, Sofie Schmid, Thorben Breitkreuz, Alexander Zimmermann, and Hans‐Henning Eckstein J Am Heart Assoc Volume 7(7):e007983 March 27, 2018 © 2018 Pavlos Tsantilas et al.

Flowchart showing inclusion and exclusion criteria applied to patients treated by CAS between 2012 and 2014 in Germany. Flowchart showing inclusion and exclusion criteria applied to patients treated by CAS between 2012 and 2014 in Germany. Special conditions include recurrent stenosis, tandem stenosis, carotid aneurysms, symptomatic ICA coiling, and symptomatic low‐grade (<50%) stenosis with ulcerated plaque morphology. *Other procedures are 68 combined or converted procedures (CAS>CEA), and 812 CAS procedures performed to obtain access for an intracranial intervention. CAS indicates carotid artery stenting; CEA, carotid endarterectomy; ICA, internal carotid artery; TIA, transient ischemic attack. Pavlos Tsantilas et al. J Am Heart Assoc 2018;7:e007983 © 2018 Pavlos Tsantilas et al.

Multivariable regression analysis. Multivariable regression analysis. Association of the (grouped) time interval between the neurologic index event and CAS with the risk of any stroke or death, any major stroke or death, and all‐cause death. Adjusted for age, sex, ASA status, type of index event, degree of ipsi‐ and contralateral stenosis, periprocedural antiplatelet therapy, pre‐ and postprocedural neurologic assessment, intraprocedural neuromonitoring, stent design, type of stent, use of an embolic protection system, annual center volume, and hospital site code. ASA indicates American Society of Anesthesiologists score; CAS, carotid artery stenting; CI, confidence interval; RR, relative risk. Pavlos Tsantilas et al. J Am Heart Assoc 2018;7:e007983 © 2018 Pavlos Tsantilas et al.

Multivariable regression analysis. Multivariable regression analysis. Association of the time interval (as a continuous variable) between the neurologic index event and CAS on A) the risk of any stroke or death (P=0.019), B) any major stroke or death (P=0.080), and C) all‐cause death (P=0.115). A relative risk of 1 corresponds to the average relative risk of all patients. Adjusted for age, sex, ASA status, type of index event, degree of ipsi‐ and contralateral stenosis, periprocedural antiplatelet therapy, pre‐ and postprocedural neurologic assessment, intraprocedural neuromonitoring, stent design, type of stent, use of an embolic protection system, annual center volume, and hospital site code. ASA indicates American Society of Anesthesiologists score; CAS, carotid artery stenting; CI, confidence interval; RR, relative risk. Pavlos Tsantilas et al. J Am Heart Assoc 2018;7:e007983 © 2018 Pavlos Tsantilas et al.