Anatomic Risk Factors | Comorbidity Risk Factors | |
---|---|---|
Group A | Group B | |
Previous carotid endarterectomy | Patients >80 years of age | NYHA class III or IV heart failure |
Contralateral carotid artery occlusion | ||
Previous radical neck dissection or radiation therapy to neck region | MI within previous 6 weeks | |
Target lesion above C2 (level of jaw) | COPD with FEV1 <30% predicted | |
Low cervical carotid lesions | ||
Dissection | Unstable angina (according to Braunwald classification) | |
Inability to extend neck (ie, cervical osteoarthritis, mobility limitations) | History of liver failure with elevated prothrombin time | |
Tandem lesions ≥70% stenosis | Elective CABG scheduled minimally 30 days after the carotid stenting procedure | |
Contralateral laryngeal palsy | ||
At risk for wound infection | ||
Tracheostomy | Severe renal failure defined as a serum creatine >2 mg/dL |
Note:—Patients are at high risk if they have (1) one or more anatomic risk factors, (2) one co-morbidity (group A) risk factor, or (3) one or more co-morbidity (group B) risk factors. NYHA indicates New York Heart Association; COPD, chronic obstructive pulmonary disease; FEV1, forced expiratory volume in 1 second; CABG, coronary artery bypass grafting.