2026-04-13T04:54:01Zhttps://recercat.cat/oai/requestoai:recercat.cat:11351/131662025-10-24T10:44:50Zcom_2072_378070com_2072_378040col_2072_378092
RECERCAT
author
Muller-Hulsbeck, Stefan
author
Vajda, Zsolt
author
ruzsa, zoltan
author
Beelen, Roel
author
Gjoreski, Aleksandar
author
Tomasello, Alejandro
author
Odrowaz-Pieniazek, Piotr
2025-10-24T10:44:50Z
2025-10-24T10:44:50Z
2025-05-29T06:39:45Z2025-05-29T06:39:45Z2025-04-12
http://hdl.handle.net/11351/13166
Carotid artery; Geographical variation; StentsArteria carótida; Variación geográfica; StentsArtèria caròtida; Variació geogràfica; StentsBackground
Regional variations in patient selection and procedural techniques for carotid artery stenting have been well documented. However, their impact on procedural outcomes, especially with the use of dual-layer micromesh stents, is not fully understood.
Methods
This prospective, multi-center observational study included 1965 patients with asymptomatic or symptomatic carotid artery stenosis treated with the Roadsaver dual-layer micromesh stent. The primary outcome measure was the 30-day rate of major adverse events, defined as any death or stroke occurring within 30 days post-procedure. This sub-analysis compared patient characteristics and procedural techniques across 13 participating countries and investigated differences in outcomes via logistic regression modelling.
Results
Patient demographics, comorbidities, and symptom presentation varied widely among countries. Similarly, the frequency of use of duplex ultrasound and diffusion-weighted magnetic resonance imaging at baseline and 30-day follow-up differed. Procedural approaches also varied, with differences in femoral access site selection (18.2% to 100.0%), use of embolic protection devices (0.0% to 100.0%), pre-dilatation (4.3% to 46.7%) and post-dilatation (66.7% to 100.0%). Although 30-day major adverse event rates differed across the compared countries, after adjusting for post-dilatation balloon pressure (categorized as no post-dilatation vs. ≤ 11atm vs. > 11atm), and the number of enrolled patients per study site, the difference became statistically non-significant.
Conclusion
Our study reveals variability in patient selection, procedural carotid stenting practices and clinical outcomes across European countries. The differences in 30-day any death or stroke rates between countries may be attributed to differing post-dilatation practices and the number of enrolled patients per study site.
Level of evidence
Level 3, observational study.The study was funded by Terumo Europe.
Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess
Pròtesis de Stent
Artèries caròtides Cirurgia
Vasos sanguinis - Malalties - Cirurgia
Avaluació de resultats (Assistència sanitària)
DISEASES::Cardiovascular Diseases::Vascular Diseases::Arterial Occlusive Diseases::Cardiovascular Diseases::Vascular Diseases::Carotid Stenosis
Other subheadings::Other subheadings::Other subheadings::/surgery
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Equipment and Supplies::Prostheses and Implants::Stents
ANATOMY::Cardiovascular System::Blood Vessels::Arteries::Carotid Arteries
Other subheadings::Other subheadings::Other subheadings::/surgery
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome
ENFERMEDADES::enfermedades cardiovasculares::enfermedades vasculares::arteriopatías oclusivas::enfermedades cardiovasculares::enfermedades vasculares::estenosis carotídea
Otros calificadores::Otros calificadores::Otros calificadores::/cirugía
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::equipos y suministros::prótesis e implantes::stents
ANATOMÍA::sistema cardiovascular::vasos sanguíneos::arterias::arterias carótidas
Otros calificadores::Otros calificadores::Otros calificadores::/cirugía
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento
Contemporary carotid artery stenting practices and peri-procedural outcomes in different European countries: ROADSAVER study multicentric insights
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion