December 31, 2012
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Statin use may diminish embolic debris during carotid stenting

Study results published in the Annals of Vascular Surgery have found that statin use is associated with less embolic debris created during carotid artery stenting.

Researchers from the department of vascular surgery at the Mount Sinai School of Medicine, New York, analyzed embolic debris from carotid filters using photomicroscopy and imaging software in 62 consecutive carotid artery stenting (CAS) procedures.

In this cohort, 41 (66%) patients were on statins at the time of stenting, and 27 (43.5%) had pre-procedural neurological symptoms. Mean intra-procedural stenosis was similar between groups (statin, 89.4 ± 7.4% vs. no statin, 88.4 ± 5.9%), and there was no significant difference in overall preoperative symptoms.

Statin users were more likely to have CAD (P=.02), hyperlipidemia (P=.047) or have undergone CABG (P=.01).

Statin use was associated with significantly less embolic particles than no statins (16.4 ± 2.1 vs. 42.4 ± 9.5; P=.001) during CAS. Multivariate analysis controlling for CAD, hyperlipidemia and CABG confirmed that statin use was independently associated with less captured debris (P=.005). There was no significant difference in the mean particle size in patients taking statins compared with those not taking statins (326.2 ± 31.1 mcm vs. 310.5 ± 41.8 mcm), nor was there a difference in peri-procedural stroke or major adverse events.

Researchers said these findings may support the notion that mechanisms other than the lipid-lowering effects of statin therapy play a role in plaque stability.

“Interestingly, those patients not receiving statin therapy generated more particles overall, and specifically an excess of debris ranging from 200 mcm to 500 mcm in largest dimension,” they wrote. “In essence, patients not receiving statin therapy are at an increased embolic risk due to plaque instability and friability.”

Disclosure: The researchers’ financial disclosures were not disclosed in the study.