Simultaneous bilateral carotid stenting in one session in high-risk patients

The authors report their experience in treating a group of 6 high-risk patients with severe bilateral carotid disease by carotid artery stenting in a single session. The patients were men aged 53 to 83 years. All had bilateral, synchronous, symptomatic ischemic disease. Five of the 6 patients had severe bilateral carotid stenoses due to atherosclerotic disease: the sixth had a dissecting aneurysm on one side. All were treated with self-expandable stents: a distal protection device was used. All stenting procedures were technically successful. Stenoses averaged 84 +/- 8% before the procedure and 10 +/- 7% after. No procedure-related complications occurred and no 30-day postoperative complications were found. One patient experienced bradhycardia and hypotension for 1 day and was treated medically. After careful preparation and perioperative procedures in a selected group of patients, simultaneous bilateral carotid stenting procedures are feasible when required and appear to be relatively safe.