Author + information
- Jing-Yi Jhang,
- Chih-Fan Yeh,
- Shyang-Rong Shih,
- Mao-Shin Lin,
- Hung-Yuan Li and
- Hsien-Li Kao
Background: Brain ischemia will affect hypothalamic-pituitary-adrenal (HPA) axis, especially in acute stage of ischemic stroke. The influence of successful carotid stenting (CS) on pituitary function in patients with ischemic severe carotid stenosis/occlusion has never been discussed.
Methods: From April 2009 to December 2014, endovascular intervention was attempted in 207 consecutive patients with severe internal carotid stenosis (ICAS) or occlusion (ICAO). 41 patients without history of head/neck radiotherapy and endocrine disease receive measurement of endocrine hormones before and at least 1 year after procedure. Computed tomography perfusion was used to assess brain perfusion.
Results: Successful recanalization was achieved in 37 of 41 patients (90.2%). The patients were divided into 3 groups: group 1 (4 patients) consisted of patients with abnormal baseline ipsilateral cerebral perfusion in whom CS failed; group 2(26 patients) consisted of patients with abnormal baseline ipsilateral cerebral perfusion in whom CS was successful; and group 3 (11 patients) consisted of patients without abnormal baseline ipsilateral cerebral perfusion in whom CS was successful. Compared with pre-procedure, only in group 2 was there significant difference in TSH (pre-procedure median [interquartile range]: 1.385 [0.78–2.59] vs. post procedure: 2.51 [1.38–3.21], p=0.0001), FSH (9.45 [4.7–34.2] vs. 14.2 [7.3–54.3], p=0.0001), and LH (5.75 [3.5–17.5] vs. 11.25 [4.8–26.8], p=0.0011), and cortisol (12.85 [9.6–14.6] vs. 16.55 [13.6–21], p=0.0025) at least 1 year after procedure. There was no significant difference in growth hormone, prolactin, DHEAS, ACTH, free T4, estradiol and testosterone, even in group 2.
Conclusions: Successful CS for severe carotid stenosis/occlusion improves pituitary function, including TSH, FSH and LH, but only in patients with objective baseline abnormal cerebral perfusion.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Head to Toe: Outcomes of Endovascular Interventions
Abstract Category: 18. Interventional Cardiology: Carotid and Endovascular Intervention
Presentation Number: 1112-121
- 2017 American College of Cardiology Foundation