{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:11:31Z","timestamp":1792098691205,"version":"4.4.0"},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2011,2]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>The purposes of this study were to assess the relationships between anatomic and technical factors and the 30-day risk of stroke or death after carotid angioplasty and stenting in the Endarterectomy versus Stenting in Patients with Symptomatic Severe Carotid Stenosis (EVA-3S) trial and to perform a systematic review of the literature.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>We included patients from EVA-3S in whom carotid stenting was attempted irrespective of allocated treatment. Two radiologists blinded to clinical data independently assessed the aortic arch and carotid arteries on procedural angiograms. In addition, we performed a systematic review of studies that reported 30-day risk of stroke or death in relation with arterial anatomy and technique. Outcomes were stroke or death and stroke occurring within 30 days of the carotid angioplasty and stenting procedure.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>Two hundred sixty-two patients from EVA-3S fulfilled the inclusion criteria (including 1 initially allocated to surgery and 13 in whom stent insertion failed).Within 30 days after the procedure, 25 (9.5%) patients had a stroke or had died. The risk of stroke or death was higher in patients with internal carotid artery\u2013common carotid artery angulation \u226560\u00b0 (relative risk, 4.96; 2.29 to 10.74) and lower in those treated with cerebral protection devices (relative risk [RR], 0.38; 0.17 to 0.85). In the systematic review (56 studies; 34 398 patients), the risk of stroke or death was higher in patients with left-sided carotid angioplasty and stenting (RR, 1.29; 1.05 to 1.58), increased internal carotid artery\u2013common carotid artery angulation (RR, 3.41; 1.52 to 7.63), and when the target internal carotid artery stenosis was &gt;10 mm (RR, 2.36; 1.28 to 3.38). There was no significant increase in risk of stroke or death in patients with Type III aortic arch, aortic arch calcification, or with ostial involvement, calcification, ulceration or degree of stenosis of the target internal carotid artery stenosis. The use of a cerebral protection device was associated with a lower risk of stroke or death (RR, 0.55; 0.41 to 0.73). Risk was not related with stent or cerebral protection device type.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Our results strongly suggest that some technical and anatomic factors, especially extreme angulation of the carotid artery, have an impact on the risks of carotid angioplasty and stenting.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.110.588772","type":"journal-article","created":{"date-parts":[[2010,12,24]],"date-time":"2010-12-24T04:39:32Z","timestamp":1293165572000},"page":"380-388","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":129,"title":["Anatomical and Technical Factors Associated With Stroke or Death During Carotid Angioplasty and Stenting"],"prefix":"10.1161","volume":"42","author":[{"given":"Olivier","family":"Naggara","sequence":"first","affiliation":[{"name":"From the Universit\u00e9 Paris Descartes, INSERM UMR 894, H\u00f4pital Sainte-Anne, Service de Radiologie (O.N., B.B., J.-F.M.) and Service de Neurologie (E.T., J.-L.M.), Paris, France; and Universit\u00e9 Paris Descartes, INSERM CIE4, Assistance Publique\u2013H\u00f4pitaux de Paris, Unit\u00e9 de recherche clinique, H\u00f4pital Europ\u00e9en Georges Pompidou (L.T., G.C.), Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Touz\u00e9","sequence":"additional","affiliation":[{"name":"From the Universit\u00e9 Paris Descartes, INSERM UMR 894, H\u00f4pital Sainte-Anne, Service de Radiologie (O.N., B.B., J.-F.M.) and Service de Neurologie (E.T., J.-L.M.), Paris, France; and Universit\u00e9 Paris Descartes, INSERM CIE4, Assistance Publique\u2013H\u00f4pitaux de Paris, Unit\u00e9 de recherche clinique, H\u00f4pital Europ\u00e9en Georges Pompidou (L.T., G.C.), Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Beyssen","sequence":"additional","affiliation":[{"name":"From the Universit\u00e9 Paris Descartes, INSERM UMR 894, H\u00f4pital Sainte-Anne, Service de Radiologie (O.N., B.B., J.-F.M.) and Service de Neurologie (E.T., J.-L.M.), Paris, France; and Universit\u00e9 Paris Descartes, INSERM CIE4, Assistance Publique\u2013H\u00f4pitaux de Paris, Unit\u00e9 de recherche clinique, H\u00f4pital Europ\u00e9en Georges Pompidou (L.T., G.C.), Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludovic","family":"Trinquart","sequence":"additional","affiliation":[{"name":"From the Universit\u00e9 Paris Descartes, INSERM UMR 894, H\u00f4pital Sainte-Anne, Service de Radiologie (O.N., B.B., J.-F.M.) and Service de Neurologie (E.T., J.-L.M.), Paris, France; and Universit\u00e9 Paris Descartes, INSERM CIE4, Assistance Publique\u2013H\u00f4pitaux de Paris, Unit\u00e9 de recherche clinique, H\u00f4pital Europ\u00e9en Georges Pompidou (L.T., G.C.), Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"Chatellier","sequence":"additional","affiliation":[{"name":"From the Universit\u00e9 Paris Descartes, INSERM UMR 894, H\u00f4pital Sainte-Anne, Service de Radiologie (O.N., B.B., J.-F.M.) and Service de Neurologie (E.T., J.-L.M.), Paris, France; and Universit\u00e9 Paris Descartes, INSERM CIE4, Assistance Publique\u2013H\u00f4pitaux de Paris, Unit\u00e9 de recherche clinique, H\u00f4pital Europ\u00e9en Georges Pompidou (L.T., G.C.), Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fran\u00e7ois","family":"Meder","sequence":"additional","affiliation":[{"name":"From the Universit\u00e9 Paris Descartes, INSERM UMR 894, H\u00f4pital Sainte-Anne, Service de Radiologie (O.N., B.B., J.-F.M.) and Service de Neurologie (E.T., J.-L.M.), Paris, France; and Universit\u00e9 Paris Descartes, INSERM CIE4, Assistance Publique\u2013H\u00f4pitaux de Paris, Unit\u00e9 de recherche clinique, H\u00f4pital Europ\u00e9en Georges Pompidou (L.T., G.C.), Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Louis","family":"Mas","sequence":"additional","affiliation":[{"name":"From the Universit\u00e9 Paris Descartes, INSERM UMR 894, H\u00f4pital Sainte-Anne, Service de Radiologie (O.N., B.B., J.-F.M.) and Service de Neurologie (E.T., J.-L.M.), Paris, France; and Universit\u00e9 Paris Descartes, INSERM CIE4, Assistance Publique\u2013H\u00f4pitaux de Paris, Unit\u00e9 de recherche clinique, H\u00f4pital Europ\u00e9en Georges Pompidou (L.T., G.C.), Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)04893-5"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa061752"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69122-8"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.108.531228"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2007.10.035"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000158921.51037.64"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60239-5"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0912321"},{"key":"e_1_3_3_10_2","first-page":"CD000515","article-title":"Percutaneous transluminal angioplasty and stenting for carotid artery stenosis","volume":"4","author":"Ederle J","year":"2007","unstructured":"Ederle J, Featherstone RL, Brown MM . 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