Hematological biomarkers for predicting carotid artery vasospasm during carotid stenting.

Introduction: The vasospasm of carotid arteries is important for the progression of neurological sequelae. Many mechanisms have been found to be related to this clinical phenomenon. Predicting this event by using hematological biomarkers may provide opportunities for adopting preventive measures against unfavorable neurovascular complications. The aim of this study is to determine the hematological predictors of carotid artery vasospasm during carotid stenting.

Material and methods: A total of 120 patients who underwent carotid stenting were divided into two groups: those with and without carotid artery vasospasm. Carotid artery vasospasm was angiographically defined as transient or persistent emergent stenosis or irregularity of the vessel wall without evidence of thrombosis during carotid stenting. The hematological parameters were compared between 21 patients who developed carotid artery vasospasm (17.5%) and 99 patients who did not (82.5%).

Results: The mean age of the patients with carotid artery vasospasm and without carotid artery vasospasm was 66 ±8 and 70 ±8 years, respectively. Creatinine levels within 0.5-0.9 (OR = 3.704, 95% CI: 1.245-11.019, p = 0.019), each 1000 unit increase in neutrophil count (OR = 1.567, 95% CI: 1.027-2.392, p = 0.037) and presence of diabetes (OR = 3.081, 95% CI: 1.116-8.505, p = 0.030) were the independent predictors of carotid artery vasospasm in carotid arteries during carotid stenting.

Conclusions: The prediction of carotid artery vasospasm during carotid stenting should help clinicians adopt preventive measures against the development of neurological sequelae. This study found that creatinine levels, increased neutrophil count and presence of diabetes are independent predictors of carotid artery vasospasm.