Relationship between Successful Cervical Carotid Stent Expansion and Low Levels of Serum Vitamin D

Abstract

Background: Serum vitamin D levels affect atherosclerosis development via diverse molecular mechanisms. The lesion characteristics of carotid stenosis affect the success of stent expansion. By comparing the pre-and post-stenting stenosis degrees, our study evaluated whether serum vitamin D levels are associated with the expansion rate of carotid stenting.Methods: Forty-six cases who underwent elective cervical carotid artery stenting were analyzed. Patients were classified into two groups according to serum total 25-hydroxy vitamin D (25[OH]D) levels; <15.1 and ≥15.1 ng/mL. The degree of stenosis before and after stent insertion was calculated using the North American Symptomatic Carotid Endarterectomy Trial (NASCET) method. The stent expansion rate was calculated as follows: (1-[post-stent stenosis degree/pre-stent stenosis degree])×100 (%). To identify the independent factors for successful stent expansion, multivariable logistic regression analysis was conducted.Results: Among the 46 patients, 25 (54.3%) had low serum 25(OH)D levels. The successful stent expansion rate was significantly higher in the low 25(OH)D level group (48.0% vs. 19.0%, respectively; p=0.04). In multivariable analysis, after adjusting for possible covariates, a low serum 25(OH)D level was independently associated with successful stent expansion (adjusted odds ratio, 6.47; 95% confidence interval, 1.11-37.80).Conclusion: Low serum vitamin D levels were independently associated with successful carotid stent expansion. This study presents a new perception of biomarkers that should be considered for satisfactory carotid artery stenting.