Simultaneous bilateral carotid stenting in high-risk patients

AJNR Am J Neuroradiol. 2010 Jun;31(6):1113-7. doi: 10.3174/ajnr.A1970. Epub 2010 Jan 6.

Abstract

Background and purpose: The safety and efficacy of SBCAS have not been evaluated in detail. The purpose of our study was to evaluate the outcome after SBCAS in high-risk patients compared with unilateral stent placement.

Materials and methods: Between March 2002 and October 2008, a total of 205 consecutive high-risk patients underwent CAS at our institution. Of these patients, 30 (14.6%) underwent SBCAS (n = 24) and staged SBCAS (n = 6). Patients who underwent unilateral CAS (n = 175) during the same period served as controls. The stroke risk factors, procedural results, and outcome at 30 days and 6 months, as well as the restenosis rate at 6 months, were compared by using either the chi(2) test or the Kruskal-Wallis equality-of-populations rank test.

Results: Our data revealed no significant differences in the stroke risk factors between the SBCAS and the control group. HPS occurred more commonly in SBCAS (ie, 16.7%, 4/24) compared with 2.9% (5/175) in the control group (P = .014). However, there was no statistical significance between 2 groups in the event rate of stroke (minor and/or major stroke), death, or restenosis at 6 months.

Conclusions: There was no significant difference in outcome at 6 months following stent placement between SBCAS and unilateral CAS in the high-risk patient group, even though HPS occurred more commonly after SBCAS.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angioplasty, Balloon / mortality*
  • Carotid Arteries / pathology
  • Carotid Stenosis / mortality*
  • Carotid Stenosis / pathology
  • Carotid Stenosis / therapy*
  • Diffusion Magnetic Resonance Imaging
  • Follow-Up Studies
  • Humans
  • Incidence
  • Postoperative Complications / mortality
  • Prospective Studies
  • Recurrence
  • Risk Factors
  • Stents*
  • Stroke / mortality*
  • Treatment Outcome