Carotid artery stenting in patients with acute coronary syndrome: a possible primary therapy for symptomatic carotid stenosis.

Abstract

PURPOSE:

To report the results of carotid artery stenting (CAS) in symptomatic patients (stroke/transient ischemic attack) after recent percutaneous transluminal coronary angioplasty (PTCA) for acute coronary syndrome (ACS).

METHODS:

Between January 2009 and July 2011, 28 consecutive patients (18 women; mean age 66 years, range 42-82) underwent protected CAS for symptomatic carotid stenosis following recent PTCA that included bare or drug-eluting stents requiring uninterrupted dual antiplatelet therapy. Primary technical success, neurological complications, major adverse cardiovascular events, and death were evaluated at 30 days and over midterm follow-up.

RESULTS:

Technical success was 96%; 1 patient suffered a nonfatal major stroke (3.5% 30-day stroke rate) during the procedure. During a median 21.6-month follow-up, 4 (14%) patients died of myocardial infarction (all diabetic smokers with ejection fractions <40%), but there were no new neurological events. Estimated survival was 89.3% at 2 years. Further coronary interventions were performed in 2 diabetic patients with a body mass index >34 kg/m(2).

CONCLUSION:

This preliminary experience demonstrated that CAS is a reasonable, safe, and effective treatment for patients with symptomatic carotid artery stenosis who were recently treated with coronary stents requiring uninterrupted dual antiplatelet therapy.

• Authors: Renato Casana, Alison Halliday, Paolo Bianchi, Emanuele Fresa, Vincenzo Silani, Gianfranco Parati, Simonetta Blengino, Lea Cireni, Laura Adobbati, Laura Calvillo, Valerio S Tolva
• Journal: Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists (J Endovasc Ther) Vol. 20 Issue 4 Pg. 546-51 (Aug 2013) ISSN: 1545-1550 [Electronic] United States
• PMID: 23914865 (Publication Type: Journal Article)

Topics

• Acute Coronary Syndrome (surgery)
• Adult
• Aged
• Aged, 80 and over
• Angioplasty, Balloon, Coronary
• Carotid Stenosis (surgery)
• Female
• Humans
• Male
• Middle Aged
• Postoperative Complications (surgery)
• Stents